Preserving or peeling the inferior mesenteric arterial sheath during laparoscopic rectal cancer surgery: a prospective study of surgical outcomes

BMC Surgery

Research

Li Xu¹  Long Qian¹  Ya-bin Xia¹  Jia-wei Wang¹  Qian Li¹  Ting-ting Cao¹  Song Wang¹  Xiao-xu Huang¹  Ye Wang¹ 

[1] Department of Gastrointestinal Surgery, First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, No. 2, Zheshan West Road, 241001, Wuhu, Anhui, China;Key Laboratory of Non-coding RNA Transformation Research of Anhui Higher Education Institution, Wuhu, Anhui, China;Non-coding RNA Research Center of Wannan Medical College, Yijishan Hospital, Wuhu, Anhui, China;

关键词: Rectal cancer;    Laparoscopic surgery;    Inferior mesenteric artery;    Sheath;    Lymph nodes;    Prospective study;   

DOI  :  10.1186/s12893-023-02083-7

 received in 2022-12-22, accepted in 2023-06-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWe mainly evaluated whether preserving the inferior mesenteric artery (IMA) sheath to dissecting IMA root lymph nodes (also called No.253 lymph nodes) would benefit patients in terms of comparable lymph-node yield removed during operation and postoperative complications in laparoscopic radical resection of rectal cancer.MethodsThis is a prospective study included 141 rectal cancer patients who received laparoscopic radical resection during September 2018 to December 2020. All patients were randomly assigned to the preserved group (n = 71) and the peeled group (n = 70). The baseline characteristics, pathological features, intraoperative and postoperative data outcomes and complications were analyzed by independent samples t test, chi-square test or Fisher’s exact test between the 2 groups.ResultsThe baseline characteristic and pathological features had no statistical difference between the 2 groups. The preserved group had a shorter operative time (P = 0.002), a shorter lymph node dissection time (P < 0.001), less intraoperative bleeding (P = 0.004), an earlier time to first flatus (P = 0.013), an earlier time to fluid intake (P = 0.033) and a shorter length of hospitalization (P = 0.012) than the peeled group. The differences between the 2 groups were not statistically significant (P > 0.05) in regard to the total number of lymph nodes cleared, positive lymph nodes, bleeding, anastomotic leakage, pneumonia, wound infection, abscess, ileus, urinary retention, urinary tract infection and chyle leakage.ConclusionPreserving of the IMA sheath in laparoscopic radical surgery for rectal cancer will reduce the total operation time and the length of hospitalization. This surgical method could lead to lower complication rate and faster recovery.Trial registrationThe study was approved by the Ethics Committee of The First Affiliated Hospital of Wannan Medical College and registered by the China Clinical Trials Registry (ChiCTR2200060830, Date of Registration:2022-06-12 -retrospective registration) http://www.chictr.org.cn/index.aspx.

【 授权许可】

CC BY   
© The Author(s) 2023

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