Yafan Yang1, Guiying Wang2, Jingli He1, Jianfeng Zhang1, Jinchuan Xi1, Feifei Wang1. 1. Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China. 2. Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China. Electronic address: wangguiyingyafan@126.com.
Abstract
BACKGROUND: Colorectal cancer surgery includes "high tie" and "low tie"of the inferior mesenteric artery(IMA). However, different ligation level is closely related to the blood supply of anastomosis, which may increase the leakage rate, and it is unclear which technique confers a lower anastomotic leakage rate(AL) and survival advantage. OBJECTIVE: To compare the effectiveness and impact of inferior mesenteric artery (IMA) high ligation versus IMA low ligation on anastomotic leakage, lymph nodes yield rates and 5-year survival. METHODS: A list of these studies, published in English from 1990 to 2017, was obtained independently by two reviewers from databases such as PubMed, Medline, ScienceDirect and Web of Science. Anastomotic leakage rate, the yield of lymph nodes and 5-year survival were compared using Review Manager 5.3. RESULTS: There was no significant difference in anastomotic leakage, number of lymph nodes retrieved and 5-year survival rate for both techniques. CONCLUSIONS: Neither the high tie nor the low tie strategy has an evidence in terms of anastomotic leakage rate, harvested lymph nodes, and the 5-year survival rate. Further RCT is needed.
BACKGROUND:Colorectal cancer surgery includes "high tie" and "low tie"of the inferior mesenteric artery(IMA). However, different ligation level is closely related to the blood supply of anastomosis, which may increase the leakage rate, and it is unclear which technique confers a lower anastomotic leakage rate(AL) and survival advantage. OBJECTIVE: To compare the effectiveness and impact of inferior mesenteric artery (IMA) high ligation versus IMA low ligation on anastomotic leakage, lymph nodes yield rates and 5-year survival. METHODS: A list of these studies, published in English from 1990 to 2017, was obtained independently by two reviewers from databases such as PubMed, Medline, ScienceDirect and Web of Science. Anastomotic leakage rate, the yield of lymph nodes and 5-year survival were compared using Review Manager 5.3. RESULTS: There was no significant difference in anastomotic leakage, number of lymph nodes retrieved and 5-year survival rate for both techniques. CONCLUSIONS: Neither the high tie nor the low tie strategy has an evidence in terms of anastomotic leakage rate, harvested lymph nodes, and the 5-year survival rate. Further RCT is needed.
Authors: Zaid Al-Difaie; Nariaki Okamoto; Max H M C Scheepers; Didier Mutter; Laurents P S Stassen; Nicole D Bouvy; Jacques Marescaux; Bernard Dallemagne; Michele Diana; Mahdi Al-Taher Journal: Surg Endosc Date: 2022-10-18 Impact factor: 3.453
Authors: Michael K Turgeon; Adriana C Gamboa; Scott E Regenbogen; Jennifer Holder-Murray; Sherif R Z Abdel-Misih; Alexander T Hawkins; Matthew L Silviera; Shishir K Maithel; Glen C Balch Journal: Dis Colon Rectum Date: 2021-10-01 Impact factor: 4.412