Mohamed, A., Moghazy, A. (2020). Comparison between High andLow Binding of the InferiorMesenteric Artery inMesorectal Excision of Rectal Tumor. The Egyptian Journal of Hospital Medicine, 80(1), 638-646. doi: 10.21608/ejhm.2020.92543
Ahmed Elsayed Mohamed; Alsayed Basiony Moghazy. "Comparison between High andLow Binding of the InferiorMesenteric Artery inMesorectal Excision of Rectal Tumor". The Egyptian Journal of Hospital Medicine, 80, 1, 2020, 638-646. doi: 10.21608/ejhm.2020.92543
Mohamed, A., Moghazy, A. (2020). 'Comparison between High andLow Binding of the InferiorMesenteric Artery inMesorectal Excision of Rectal Tumor', The Egyptian Journal of Hospital Medicine, 80(1), pp. 638-646. doi: 10.21608/ejhm.2020.92543
Mohamed, A., Moghazy, A. Comparison between High andLow Binding of the InferiorMesenteric Artery inMesorectal Excision of Rectal Tumor. The Egyptian Journal of Hospital Medicine, 2020; 80(1): 638-646. doi: 10.21608/ejhm.2020.92543
Comparison between High andLow Binding of the InferiorMesenteric Artery inMesorectal Excision of Rectal Tumor
1Department of Surgical Oncology, Faculty of Medicine, Al-Azhar University, Cairo Egypt
2Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo Egypt
Abstract
Background: Colorectal tumor is one of the most common tumors in both men and women worldwide. However, whether high or low inferior mesenteric artery (IMA) ligation should be performed in the laparoscopic resection of resectable rectal tumor remains controversial. Objectives: The aim of the work was to compare low vs high IMA binding in patients undergoing laparoscopic mesorectal excision for rectal tumor. Patients and methods: This retrospective archived-based data study included a total of 161 patients with rectal tumor who were eligible for total mesorectal excision, attending at Al-Azhar University Hospitals. This study was conducted between 2010, and 2017. The high IMA binding (HIMAB) was conducted for 87 patients and low IMA binding (LIMAB) was conducted for 74 patients. Baseline data were retrospectively analyzed for patients in both groups. Results: The LIMAB group showed more high anus retention ratio (P = 0.022), more brief hospital stay (P = 0.025), less medical costs (P = 0.032), lower anastomotic leakage (P = 0.023), and lower frequency of postoperative genitourinary dysfunction (P = 0.003) when compared with HIMAB group. Analysis of the Cox regression showed local recurrence, distant metastases, tumor differentials. Conclusion: It could be concluded that laparoscopic radical rectal cancer resection with low IMA binding tends to be correlated with reduced anastomotic leakage risk, anastomotic stringency risk, the risk of instability of the genitourinary system, less time of hospitalization, and decreased costs. By comparison, it was found that the rate of excised lymph node, tumor recurrence, metastasis, or mortality was not associated with the level of IMA binding
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