Abstract
AIM: to compare methods of high and low ligation of the inferior mesenteric artery (IMA) in relation to early and late outcomes in surgery for rectal and sigmoid cancer.MATERIALS AND METHODS: the systematic review performed in accordance with PRISMA practice and guidelines.RESULTS: eighteen studies (5 randomized clinical trials and 13 retrospective studies) are included in the study. The meta-analysis demonstrated that left colic artery (LCA) preservation significantly reduced the incidence of anasto- motic leaks compared with high ligation of IMA (OR = 1.60; CI 1.23–2.10; p = 0.0006). There were no differences in operation time, blood loss, frequency of splenic flexure mobilization, number of harvested lymph nodes, incidence of urinary dysfunction, postoperative hospital stay and 5-year disease-free survival.CONCLUSION: low ligation of the IMA improves the blood supply to the anastomosis and reduces the risk of anasto- motic leakage.
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