Indication for using high ligation of the inferior mesenteric artery in rectal cancer surgery

Hida, Jin‐ichi; Yasutomi, Masayuki; Maruyama, Takamasa; Fujimoto, Kiyoshige; Nakajima, Ayako; Uchida, Toshihiro; Wakano, Tsukasa; Tokoro, Tadao; Kubo, Rieko; Shindo, Katsuhisa

doi:10.1007/bf02237385

Cited by 44 publications

(39 citation statements)

References 13 publications

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“…In a retrospective analysis of 198 cases of rectal cancer, metastases at the root of the IMA were found in 8.6% of the patients [39]. None of the 46 patients with pT1 or pT2 tumours presented IMA root nodal metastases.…”

Section: Resultsmentioning

confidence: 99%

“…Despite the fact that approximately one fifth of the patients experience significant blood flow reduction after IMA clamping, ischaemia-related anastomotic complications are encountered in around 5% of the cases, mostly elderly male patients [48]. Furthermore, a study comparing tissue oxygenation proximal to the colonic resection margin demonstrated that the marginal artery provides an adequate vascular supply to the transverse and descending colon [49], thus explaining the low anastomotic leak rates reported after high IMA ligation [39, 45, 46, 50]. Although the superior hypogastric nerves are at risk, ligation of the IMA at its origin is the safest option in order to avoid damage to the autonomic nerves [51, 52], which permits preservation of sexual and urinary functions in the great majority of the patients [35, 36, 53].…”

Section: Discussionmentioning

confidence: 99%

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High Tie of the Inferior Mesenteric Artery in Curative Surgery for Left Colonic and Rectal Cancers: A Systematic Review

Titu

Tweedle²,

Rooney³

2008

Dig Surg

134

109

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Background: During surgery for left colonic and rectal cancers, the inferior mesenteric artery (IMA) can be ligated either at its aortic origin (high tie) or below the origin of the left colic artery (low tie). There is no consensus as to which method should be employed. Methods: We searched Medline, EMBASE, Cochrane collaboration, and National Guidelines Clearinghouse databases and undertook a systematic review on the use of IMA high tie during curative resections for left colonic and rectal cancers and its impact on patient survival, peri-operative morbidity and mortality, and lymph node retrieval rates. Results: Sixteen studies were eligible for systematic review, including one randomized controlled study, 7 quasi-experimental studies, and 8 retrospective cohort studies. Data on 7,649 patients were analyzed, of whom 4,847 underwent high ligation of the IMA. Despite a trend for improved survival in patients in whom high tie was employed, there is no conclusive evidence to support this. Mortality and morbidity, including anastomotic leak and autonomic nerve injury rates, are similar, while lymph node retrieval is improved. Conclusions: Although there is no undisputable evidence of improved survival, the use of IMA high tie contributes to improved lymph node retrieval rates and accuracy of tumour staging.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

High Tie of the Inferior Mesenteric Artery in Curative Surgery for Left Colonic and Rectal Cancers: A Systematic Review

Titu

Tweedle²,

Rooney³

2008

Dig Surg

134

109

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“…21 Moreover, the incidence of IMA lymph node metastasis was 4.79% in our study and was reported in previous studies to be low, ranging from 0.3% to 8.6%. 16,20,22,23 This low incidence could also be one of the reasons that we and others could not demonstrate a survival benefit. Taken together, there is no conclusive evidence to support a survival benefit among patients who undergo removal of IMA lymph node by high ligation.…”

Section: Discussionmentioning

confidence: 67%

Inferior Mesenteric Artery Lymph Node Metastasis Is an Independent Prognostic Factor for Stage III Sigmoid Colon and Rectal Cancer

Hata

Takahashi

Haraguchi

et al. 2017

International Surgery

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Abstract:Background: It is unclear whether the number or distribution of lymph node metastases can provide a more accurate prognosis. The aim of this study was to evaluate the prognostic impact of inferior mesenteric artery (IMA) lymph node metastasis (LNM) in sigmoid colon and rectal cancer. Methods: We included 188 patients who underwent curative resection for stage III sigmoid colon and rectal cancer between January 2001 and December 2012. Patients were divided into two groups based on the presence of IMA LNM (LNM-positive vs. LNM-negative group). Clinicopathological characteristics, 3-year recurrence-free survival and 5-year overall survival rates, and recurrence patterns were compared between the two groups. Results: Of 188 patients, nine patients (4.79%) were in the LNM-positive group. After curative resection, 3-year recurrence-free survival and 5-year overall survival rates were significantly lower in the LNM-positive group compared to the LNM-negative group (44.44% vs. 69.98%, p = 0.016 for 3-year recurrence-free survival and 48.61% vs. 81.73%, p = 0.018 for 5-year overall survival). Multivariate analysis revealed that the presence of IMA LNM (p = 0.04), not the number of LNMs (p = 0.153), was an independent prognostic factor for recurrence-free survival. The paraaortic lymph node metastasis rate was significantly higher in the LNM-positive group (p = 0.0078). Conclusions: IMA LNM is an independent predictor of survival for stage III sigmoid Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporationcolon and rectal cancer patients. Evaluation of IMA LNM enables accurate estimation of patient prognosis and enhances appropriate postoperative therapy. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation Inferior Mesenteric Artery Lymph Node Metastasis Is an Independent

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“…A avaliação do perfi l qualitativo dos LN tem assumido importância crescente. Nesse contexto, o estudo do LN sentinela (6,10) (LN que recebe drenagem linfática diretamente da lesão primária), do tamanho dos LN (10) e das metástases nos LN (26,32) , da localização dos LN em relação à topografi a da lesão (8) , à proximidade do tumor (11) e de tronco vascular específi co (16) têm sido avaliados em relação ao prognóstico. O uso da imunoistoquímica mostrou-se método efi ciente na detecção de micrometástases (metástases menores que 2 mm) (6) , com impacto no estádio e no prognóstico dos pacientes (6,7,12) .…”

Section: Introductionunclassified

Acometimento metastático linfonodal no câncer colorretal

Pereira

Torres

Nogueira

2006

Arq. Gastroenterol.

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Indication for using high ligation of the inferior mesenteric artery in rectal cancer surgery

Cited by 44 publications

References 13 publications

High Tie of the Inferior Mesenteric Artery in Curative Surgery for Left Colonic and Rectal Cancers: A Systematic Review

High Tie of the Inferior Mesenteric Artery in Curative Surgery for Left Colonic and Rectal Cancers: A Systematic Review

Inferior Mesenteric Artery Lymph Node Metastasis Is an Independent Prognostic Factor for Stage III Sigmoid Colon and Rectal Cancer

Acometimento metastático linfonodal no câncer colorretal

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