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首页> 外文期刊>Surgery today >High ligation of the inferior mesenteric artery in rectal cancer surgery
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High ligation of the inferior mesenteric artery in rectal cancer surgery

机译：直肠癌手术中肠系膜下动脉高位结扎

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In rectal cancer surgery, it is unclear whether the inferior mesenteric artery (IMA) should be ligated as high as possible, at its origin, or low, below the origin of the left colic artery. We reviewed all relevant articles identified from MEDLINE databases and found that despite a trend of improved survival among patients who underwent high ligation, there is no conclusive evidence to support this. High ligation of the IMA is beneficial in that it allows for en bloc dissection of the node metastases at and around the origin of the IMA, while enabling anastomosis to be performed in the pelvis, without tension, at the time of low anterior resection. High ligation of the IMA does not represent a source of increased anastomotic leak in rectal cancer surgery and postoperative quality of life is improved by preserving the hypogastric nerve without compromising the radicality of the operation. More importantly, high ligation of the IMA improves node harvest, enabling accurate tumor staging. Although the prognosis of patients with node metastases at and around the origin of the IMA is poor, the survival rate of patients with rectal cancer may be improved by performing high ligation of the IMA combined with neoadjuvant and adjuvant therapy.
机译：在直肠癌手术中，不清楚肠系膜下动脉（IMA）是否应在其起点处尽可能高的结扎，或在左结肠动脉的起点下方应结扎。我们审查了从MEDLINE数据库中鉴定出的所有相关文章，发现尽管进行高结扎的患者有提高生存率的趋势，但没有确凿的证据支持这一点。 IMA的高结扎是有益的，因为它允许对IMA起点及其周围的淋巴结进行整体解剖，同时在低位前切除术时能够在骨盆中进行吻合而无张力。 IMA的高结扎率并不代表直肠癌手术中吻合口漏增加，并且可以通过保留下胃神经而不损害手术的根本性来改善术后生活质量。更重要的是，IMA的高结扎可改善结节收获，从而实现准确的肿瘤分期。尽管在IMA起源及其周围发生淋巴结转移的患者的预后较差，但通过结扎IMA高剂量并结合新辅助治疗和辅助治疗，可以提高直肠癌患者的生存率。

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