Controversy and progress on whether to retain left colonic artery in radical resection of rectal cancer.
10.3760/cma.j.cn.441530-20200922-00534
- Author:
Chao Hui ZHEN
1
;
Jin Feng ZHU
1
;
Ruo Dai WU
2
;
Biao ZHENG
1
;
Heng Liang ZHU
1
;
Zhi Wu ZENG
1
;
Rui LIANG
1
;
Shi Jian YI
1
;
Zhong LIU
1
;
Peng GONG
1
Author Information
1. Department of General Surgery, Shenzhen University General Hospital, Shenzhen 518055, China.
2. Department of Radiology, Shenzhen University General Hospital, Shenzhen 518055, China.
- Publication Type:Review
- Keywords:
Anastomotic leak;
Colorectal neoplasms;
Inferior mesenteric artery;
Left colic artery
- MeSH:
Arteries;
Humans;
Laparoscopy;
Mesenteric Artery, Inferior/surgery*;
Quality of Life;
Rectal Neoplasms/surgery*
- From:
Chinese Journal of Gastrointestinal Surgery
2021;24(8):735-740
- CountryChina
- Language:Chinese
-
Abstract:
Japanese Society for Cancer of the Colon and Rectum (JSCCR) guideline 2019 recommended that lymph node dissection for advanced rectal cancer should include the lymphatic adipose tissue at the root of the inferior mesenteric vessels, but the ligation site of the inferior mesenteric artery (IMA) was not determined, and the NCCN guideline did not indicate clearly whether to retain the left colonic artery (LCA). Controversy over whether to retain LCA is no more than whether it can reduce the incidence of anastomotic complications or postoperative functional damage without affecting the patients' oncological outcome. Focusing on the above problems, this paper reviews the latest research progress. In conclusion, it is believed that the advantages of retaining LCA are supported by most studies, which can improve the blood supply of the proximal anastomosis, and technically can achieve the same range of lymph node dissection as IMA high ligation. However, whether it affects the survival of patients, reduces the incidence of anastomotic leakage, and improves the quality of life of patients, more high-quality evidence-based medical evidence is still needed.
