Low Tie Compared to High Tie Vascular Ligation of the Inferior Mesenteric Artery in Rectal Cancer Surgery Decreases Postoperative Complications Without Affecting Overall Survival.
Adult
Aged
Aged, 80 and over
Female
Humans
Ligation
/ methods
Lymph Node Excision
Male
Mesenteric Artery, Inferior
/ pathology
Middle Aged
Neoadjuvant Therapy
/ adverse effects
Neoplasm Recurrence, Local
/ radiotherapy
Postoperative Complications
/ epidemiology
Rectal Neoplasms
/ pathology
Rectum
/ pathology
Rectal cancer
high tie
inferior mesenteric artery
low tie
vascular ligation
Journal
Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
13
05
2019
revised:
06
06
2019
accepted:
07
06
2019
entrez:
2
8
2019
pubmed:
2
8
2019
medline:
8
8
2019
Statut:
ppublish
Résumé
The aim of this study was to determine the clinical impact of low tie ligation (LT) of the inferior mesenteric artery (IMA) below the left colic artery versus high tie ligation (HT) at the origin of the IMA in patients undergoing rectal cancer surgery. Between January 2005 and December 2017, all consecutive patients who underwent rectal resection for non-metastatic cancer were retrospectively included. Patients who had LT were compared to those who had HT. Overall, 200 patients were identified (101 HT and 99 LT). Postoperative 30-day mortality rate was nil in both groups. There were significantly higher severe postoperative complications in HT versus LT patients (Clavien-Dindo III-IV) (18.8% vs. 9.1%, p=0.048). Median follow-up was 38.5 months and overall survival at 5 years was 91.5% and there was no difference between the two groups (90.1% vs. 92.9%; HT vs. LT p=0.640). LT ligation of IMA significantly decreased the severe postoperative complication rate without affecting recurrence-free or overall survival.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
The aim of this study was to determine the clinical impact of low tie ligation (LT) of the inferior mesenteric artery (IMA) below the left colic artery versus high tie ligation (HT) at the origin of the IMA in patients undergoing rectal cancer surgery.
PATIENTS AND METHODS
METHODS
Between January 2005 and December 2017, all consecutive patients who underwent rectal resection for non-metastatic cancer were retrospectively included. Patients who had LT were compared to those who had HT.
RESULTS
RESULTS
Overall, 200 patients were identified (101 HT and 99 LT). Postoperative 30-day mortality rate was nil in both groups. There were significantly higher severe postoperative complications in HT versus LT patients (Clavien-Dindo III-IV) (18.8% vs. 9.1%, p=0.048). Median follow-up was 38.5 months and overall survival at 5 years was 91.5% and there was no difference between the two groups (90.1% vs. 92.9%; HT vs. LT p=0.640).
CONCLUSION
CONCLUSIONS
LT ligation of IMA significantly decreased the severe postoperative complication rate without affecting recurrence-free or overall survival.
Identifiants
pubmed: 31366531
pii: 39/8/4363
doi: 10.21873/anticanres.13605
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4363-4370Informations de copyright
Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.