1
Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
2
Department of Surgical Oncology, El-Salam Oncology Center, Cairo, Egypt
10.21608/asjs.2025.418416.1235
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.
Omar, H., El Shayeb, A., Abdel Rasoul, E., Khalifa, A., & Elbarmelgi, M. (2025). Comparative Study between High and Low Inferior Mesenteric Artery Ligation in Laparoscopic Total Mesorectal Excision in Rectal Cancer Patients. Ain Shams Journal of Surgery, 18(4), 374-382. doi: 10.21608/asjs.2025.418416.1235
MLA
Haitham S. E. Omar; Amr M. El Shayeb; Eslam A. Abdel Rasoul; Ahmed S. Khalifa; Mohamed Yehia Elbarmelgi. "Comparative Study between High and Low Inferior Mesenteric Artery Ligation in Laparoscopic Total Mesorectal Excision in Rectal Cancer Patients", Ain Shams Journal of Surgery, 18, 4, 2025, 374-382. doi: 10.21608/asjs.2025.418416.1235
HARVARD
Omar, H., El Shayeb, A., Abdel Rasoul, E., Khalifa, A., Elbarmelgi, M. (2025). 'Comparative Study between High and Low Inferior Mesenteric Artery Ligation in Laparoscopic Total Mesorectal Excision in Rectal Cancer Patients', Ain Shams Journal of Surgery, 18(4), pp. 374-382. doi: 10.21608/asjs.2025.418416.1235
VANCOUVER
Omar, H., El Shayeb, A., Abdel Rasoul, E., Khalifa, A., Elbarmelgi, M. Comparative Study between High and Low Inferior Mesenteric Artery Ligation in Laparoscopic Total Mesorectal Excision in Rectal Cancer Patients. Ain Shams Journal of Surgery, 2025; 18(4): 374-382. doi: 10.21608/asjs.2025.418416.1235
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