Comparative Study between High and Low Inferior Mesenteric Artery Ligation in Laparoscopic Total Mesorectal Excision in Rectal Cancer Patients | ||
| Ain Shams Journal of Surgery | ||
| Volume 18, Issue 4, October 2025, Pages 374-382 PDF (394.19 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/asjs.2025.418416.1235 | ||
| Authors | ||
| Haitham S. E. Omar* 1; Amr M. El Shayeb1; Eslam A. Abdel Rasoul2; Ahmed S. Khalifa1; Mohamed Yehia Elbarmelgi1 | ||
| 1Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt | ||
| 2Department of Surgical Oncology, El-Salam Oncology Center, Cairo, Egypt | ||
| Abstract | ||
| Introduction: Surgery is the primary treatment for rectal cancer, with laparoscopy improving visualization during total mesorectal excision (TME). There are two techniques for ligating the inferior mesenteric artery (IMA): high ligation at its aortic origin and low ligation after branching the left colic artery. Aim of work: The present study aims to evaluate the difference between high and low ligation of the (IMA) regarding healing; vascularity and recurrence after laparoscopic (TME) in cases of rectal cancer Patients and methods: This prospective / retrospective study was conducted on 43 patients with rectal cancer at two tertiary hospitals from January 2014 to December 2017. The patients were divided into two groups: high ligation of the inferior mesenteric artery group (HL) (19 cases), and a group that underwent low ligation (LL) of the artery (21 cases); another 3 patients underwent a new approach described as functional high ligation (FHL). Retrospective cases were followed up for 4 years postoperatively. Results: Our study revealed no significant difference between the two groups regarding complications. Leakage occurred in 3 cases with high ligation and 2 cases with low ligation of IMA. Sloughing of the stoma was encountered in 2 cases done with high ligation and 1 case done with low ligation of IMA. Follow-up revealed 2 cases of recurrence; one case in each group Conclusion: No difference was found between high and low ligation of the inferior mesenteric artery in laparoscopic total mesorectal excision (TME) in cases of cancer rectum regarding complications. | ||
| Keywords | ||
| Rectal carcinoma; total mesorectal excision; inferior mesenteric artery ligation; laparoscopy | ||
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