Effect of Left Colonic Artery Preservation on Anastomotic Leakage in Laparoscopic Anterior Resection for Middle and Low Rectal Cancer

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2013 Sep 6

PMID 24005279

Citations 51

Authors

Takao Hinoi

Masazumi Okajima

Manabu Shimomura

Hiroyuki Egi

Hideki Ohdan

Fumio Konishi

Kenichi Sugihara

Masahiko Watanabe

Affiliations

Soon will be listed here.

Abstract

Background: High morbidity rates related to anastomotic leakage and other factors restrict the application of laparoscopic rectal excision. The aim of the present study was to assess the effect of left colonic artery (LCA) preservation on postoperative complications after laparoscopic rectal excision.

Methods: Data from 888 patients from 28 leading hospitals in Japan who underwent laparoscopic-assisted sphincter-preserving resection of middle and low rectal cancers between 1994 and 2006 were analyzed. The effects of LCA preservation were analyzed among all anterior resection (AR) cases (n = 888) and among AR cases with radical lymph node excision (n = 411).

Results: Among all AR cases, the tumor size, number of lymph nodes collected with evidence of metastasis, TNM factor, and TNM staging were smaller in the LCA preservation group. Regarding complications, the rate of anastomotic leak was significantly higher in the LCA non-preservation group among all AR cases, as well as among AR cases with radical lymph node excision. Nevertheless, there was no difference in survival rate between LCA preservation group and non-preservation group, as measured by the Kaplan-Meier method.

Conclusions: Our data suggest that the preservation of the LCA in laparoscopic AR for middle and low rectal cancer is associated with lower anastomotic leak rates.

Citing Articles

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Lee M, Park S, You K, Lee D, Lee D, Park S Ann Coloproctol. 2024; 40(1):62-73.

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