Preservation or nonpreservation of left colic artery in rectal and sigmoid cancer surgery | ||||
| The Egyptian Journal of Surgery | ||||
| Article 9, Volume 42, Issue 1, January 2023 PDF (3.57 MB) | ||||
| DOI: 10.4103/ejs.ejs_6_23 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Hady Abou-Ashour; Asem Fayed Mustafa; Mohamed Mamdouh Asar | ||||
| Abstract | ||||
| Background It is unclear whether to preserve the left colic artery (LCA) for sigmoidectomy or not in cancer surgery. The objective of this study was to assess the value of preservation of LCA in sigmoidectomy in cancer surgery. Patients and methods A total of 55 patients with rectal and sigmoid cancer were admitted to the Menoufia University Hospital (General Surgery Department) and Al-Azhar University Hospital (General Surgery Department). Patients were randomized into two groups: group A included nonpreservation of LCA (28 patients), and group B included preservation of LCA (27 patients). Our oncologic considerations were the number of apical lymph nodes, overall recurrence, 1-year overall survival (disease-free survival), 30-day postoperative morbidity, 30-day postoperative mortality, anastomotic leakage, and urogenital and defecatory dysfunction. Results In our study, 55 individuals were included (28 received LCA nonpreservation surgery and 27 got LCA preservation surgery). Anastomotic leakage was much lower (3.7%) in the LCA preservation group compared with the nonpreservation group (10.7%). There were no significant differences between the LCA nonpreservation and LCA preservation groups in terms of sexual dysfunction, urine retention, the number of apical lymph nodes, short-term oncologic outcomes, operation time, blood loss, and perioperative morbidity and death. Conclusions LCA preservation revealed less anastomotic leakage than LCA nonpreservation in rectosigmoid cancer surgery. Future large volume carefully crafted randomized controlled studies are required to build solid evidence about this issue. | ||||
| Keywords | ||||
| high ligation; left colic artery preservation; low ligation; rectosigmoid cancer | ||||
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