Preservation of the inferior mesenteric artery in colorectal resection for complicated diverticular disease

Oncological Impact of Laparoscopic Lymphadenectomy with Preservation of the Left Colic Artery for Advanced Sigmoid and Rectosigmoid Colon Cancer

“…For example, Dworkin et al [11] and Seike et al [12] used Doppler flowmetry to demonstrate that IMA clamping resulted in a >50% blood-flow reduction to the anastomosis, and a randomised controlled trial by Tocchi et al [23] reported that anastomotic leakages were significantly more frequent following HL of the IMA for diverticular disease in the left colonthan the preservation of the IMA and the LCA. Corder et al [24] and Hall et al [25] reported that HL of the IMA does not affect anastomotic leakage rates in the context of oncologic surgeries, while Kobayashi et al [19] and Sekimoto et al [20] demonstrated that operative results were not significantly different when comparing HL of the IMA and the preservation of the IMA and the LCA during laparoscopic surgeries.…”

Laparoscopic lymph node dissection around the inferior mesenteric artery with preservation of the left colic artery

“…Furthermore, other reports discussed the influence of IMA ligation on anastomotic leakage. Tocchi et al [10] assessed the influence of IMA preservation on the leakage rate in 163 cases with diverticular disease in the left colon in a randomized controlled study, and indicated that radiologically and clinically detected leakages were significantly higher with ligation of the IMA. With regard to cancer surgery, Corder et al [11] reported that the leak rate was not different between high tie and low tie; however, their study was retrospective in BMI body mass index a American Society of Anesthesiologists (ASA) physical status classification system: (1) a normal healthy patient, (2) a patient with mild systemic disease, (3) a patient with severe systemic disease, (4) a patient with severe systemic disease posing a constant threat to life, (5) a moribund patient who was not expected to survive without the operation, (6) a declared brain-dead patient whose organs were dissected out for donation.…”

Preservation of the superior rectal artery

“…Meta-analysis failed to demonstrate a significant influence of preservation of the SRA on anastomotic leak rates. However, within an individual consideration of the different studies, leak rate of the only randomized trial could be shown to be significantly lower after SRA preservation (p = 0.03, [16] section rectopexy with SRA preservation [13]. However, the study was retrospectively conducted and neither controlled nor randomized and thereby of low quality.…”