Does sacrifice of the inferior mesenteric artery or superior rectal artery affect anastomotic leak following sigmoidectomy for diverticulitis? a retrospective review

Low ligation inferior mesenteric artery versus selective sigmoidal artery ligation in sigmoid colon cancer: a comparative study

“…11 Similar to Lehmann et al, did not find the ligation of IMA or SRA to be associated with increased anastomosis leakage. 6 However, both studies were done in sigmoid diverticulitis patients. The authors' study, there was no anastomosis leakage found and good blood supply was observed in both groups.…”

“…6 Concerns of high ligation of IMA may injury the autonomic nerve fibers of the inferior mesenteric pre-aortic plexus resulting in sympathetic denervation of the rectal stump and contributing to anterior resection syndrome which comprises of fecal incontinence, urgency, frequency, and fragmentation. [7][8][9] Previous studies have compared the high-tie versus lowtie of IMA and most of them found no significant difference in the overall 30-day post-operative morbidity and mortality, anastomosis leakage, 5-year survival rate and the overall survival rate.…”

“…[1][2][3][4][5] However, high ligation of the IMA may compromise the blood flow of the anastomosis and contribute to anastomosis ischemia and leakage. 6 Concerns of high ligation of IMA may injury the autonomic nerve fibers of the inferior mesenteric pre-aortic plexus resulting in sympathetic denervation of the rectal stump and contributing to anterior resection syndrome which comprises of fecal incontinence, urgency, frequency, and fragmentation.…”

Failure to Use Ultrasound Is a Glaring Shortcoming

“…colica sinistra gingen aber univariat und multivariat mit einer signifikant erhöhten Leckrate einher. Dem steht eine retrospektive Studie an 130 Divertikulitis-Patienten entgegen, die bei einer Gesamtinsuffizienzrate von 5,4% keinen Einfluss der Gefäßabsetzung finden konnte [451] …”

Preservation of the superior rectal artery

“…Ischemia of the anastomotic region counts to the most meaningful factors, leading to anastomotic leakage. Therefore, the preservation of the anatomical blood supply of the rectum was investigated concerning its impact on anastomotic healing by several authors, commonly focusing on the inferior mesenteric artery (IMA, [4,5]). Valdoni et al first described the technique of sigmoidectomy with preservation of the IMA in 1972 [6].…”