Influence of high ligation of the inferior mesenteric artery on postoperative complications after radical resection of rectal cancer

Abstract

Objective To identify the risk factors for postoperative complications after radical resection of rectal cancer, and study the influence of high ligation of the inferior mesenteric artery on postoperative complications of rectal cancer. Methods Clinical data of the patients who underwent radical resection of rectal cancer in the Affiliated Hospital of North Sichuan Medical College from January 2011 to December 2015 were analyzed. The χ2 test and t test were used for all the data. Results A total of 431 patients with rectal cancer were included, of which 80 cases were excluded, and finally 351 cases met the standard. Among them, 196 cases were in high ligation group, and 155 cases were in low ligation group. The total incidence of postoperative complications was 20.4% (40/196) in the high ligation group and 27.1% (42/155) in the low ligation group respectively, the difference of which was not statistically significant (χ2 = 1.336, P = 0.245). The incidence of anastomotic leakage was 10.2% (20/196) in the high ligation group and 7.7% (12/155) in the low ligation group respectively, and there was no significant difference between them (χ2 = 0.529, P = 0.467). Logistic regression analysis revealed that gender (OR = 2.102, 95% CI 1.278-3.459, P = 0.003), body mass index (OR = 2.492, 95% CI 1.070-5.800, P = 0.027), with or without anemia before surgery (OR = 2.203, 95% CI 1.085-4.472, P = 0.029), and location of tumor (OR = 2.861, 95% CI 1.288-16.007, P = 0.019) were independent risk factors for postoperative complications. Conclusions High ligation of the inferior mesenteric artery does not increase the incidence of postoperative complications after radical resection of rectal cancer. Anastomotic leakage after rectal cancer resection is related to gender, body mass index, with or without anemia before surgery, and location of tumor. Key words: Rectal neoplasms; Laparoscopic; Inferior mesenteric artery; Anastomotic leakage