title: Marginal artery stump pressure in left colic artery-preserving rectal cancer surgery: a clinical trial.
abstract: BACKGROUND
  The aim of this clinical trial is to evaluate the influence of high and low ligation of the inferior mesenteric artery with apical lymph node dissection on the anastomotic blood supply, lymph node retrieval rate, operative time and anastomotic leakage rate in rectal cancer surgery.
  
  
  METHODS
  A total of 57 Chinese patients were randomly distributed into group A and group B and underwent radical resection of rectal cancer. Patients in group A underwent high ligation of the inferior mesenteric artery, and patients in group B underwent apical lymph node resection around the root of the inferior mesenteric artery with preservation of the left colic artery. The marginal artery stump pressure was measured after colon and artery reconstruction. Systemic pressure, distal colon length, operative time and lymph node retrieval rate were measured and recorded. The results were analysed and related to patient characteristics and post-operative complications.
  
  
  RESULTS
  The anastomotic blood supply negatively and linearly correlated with age and distal colon length and showed a positive linear correlation with systemic pressure. Patients who received low ligation with apical lymph node dissection had a better anastomotic blood supply than those who received high ligation. No differences were found in lymph node retrieval rate, operative time and anastomotic leakage rate. Anastomotic leakage was associated with a worse anastomotic blood supply.
  
  
  CONCLUSIONS
  Low ligation with apical lymph node dissection in rectal cancer treatment provides better anastomotic blood supply but is not associated with differences in node retrieval rate or operation time.
authors.affiliation: Department of Gastrointestinal Surgery, First Hospital of Jilin University, Changchun, China.
authors.forename: Yuchen
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Gastrointestinal Surgery, First Hospital of Jilin University, Changchun, China.
authors.forename: Daguang
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Gastrointestinal Surgery, First Hospital of Jilin University, Changchun, China.
authors.forename: Liang
authors.initials: L
authors.lastname: He
authors.affiliation: Department of Gastrointestinal Surgery, First Hospital of Jilin University, Changchun, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: College of Mathematics, Jilin University, Changchun, China.
authors.forename: Shishun
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Gastrointestinal Surgery, First Hospital of Jilin University, Changchun, China.
authors.forename: Luyao
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Gastrointestinal Surgery, First Hospital of Jilin University, Changchun, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Gastrointestinal Surgery, First Hospital of Jilin University, Changchun, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Suo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000453:epidemiology; D001158:Arteries; D003106:Colon / Q000098:blood supply*; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D008026:Ligation / Q000379:methods; D008197:Lymph Node Excision; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000601:surgery; D008875:Middle Aged; D061646:Operative Time; D059351:Organ Sparing Treatments; D012004:Rectal Neoplasms / Q000601:surgery*
keywords: anastomosis; apical lymph nodes; colorectal surgery; inferior mesenteric artery; stump pressure