Location of inferior mesentery artery ligation in rectal cancer surgery: how to make decisions based on available evidence.
10.3760/cma.j.cn441530-20220106-00015
- Author:
Yi XIAO
1
Author Information
1. Division of Colorectal Surgery, Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China.
- Publication Type:Journal Article
- Keywords:
Inferior mesenteric artery;
Lymph node dissection;
Rectal neoplasms
- MeSH:
Humans;
Laparoscopy/methods*;
Ligation/methods*;
Lymph Node Excision/methods*;
Mesenteric Artery, Inferior/surgery*;
Mesentery;
Rectal Neoplasms;
Rectum/surgery*;
Retrospective Studies
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(4):290-294
- CountryChina
- Language:Chinese
-
Abstract:
There are still controversies as to the location of ligating the inferior mesenteric artery and the central lymph node dissection during rectal cancer surgery. The reason is that the level of evidence in this area is low. Existing studies are mostly retrospective, analyses or small-sample randomized controlled trials. These results showed no significant differences between high-ligation and low-ligation, in terms of anastomotic leakage and other short-term postoperative complications. Low-ligation seems better for the recovery of postoperative genitourinary function. Due to the low rate of central lymph node metastasis and many other confounding factors that affect the survival rate, it is difficult to conclude the survival benefits of ligation site or central node dissection. It is necessary to carry out some targeted, well-designed, large-scale randomized controlled trials to explain the related issues of inferior mesenteric artery ligation site and extent of central lymphadenectomy.
