To analyze the influence of different ligation planes of inferior mesenteric artery on the prognosis of rectal cancer patients undergoing laparoscopic anterior resection.

The clinical data of one hundred and thirty-six patients with rectal cancer undergoing anterior resection in Qingdao Municipal Hospital from June 2007 to June 2014 were retrospectively analyzed. According to different levels of inferior mesenteric artery ligation, the patients were divided into two groups. Low ligation group (LL) contained 76 patients with left colonic artery preserved, and high ligation group (HL) contained 60 patients with left colonic artery resected. The perioperative indicators and prognosis of the two groups were evaluated.

There were no significant differences in operation time, intraoperative bleeding volume, postoperative anal exhaust time, the total number of lymph nodes dissection or the number of No.253 lymph nodes dissection between the two groups (t=6.109, 4.339, 8.386, 0.233, 0.198, P=0.318, 0.416, 0.512, 0.821, 0.669). Compared with HL group, the incidence of anastomotic leakage in LL group was significantly lower (χ²=5.186, P=0.029). There were no significant differences between the two groups in the overall 3, 5-year survival rates with 80.00% and 73.33% in HL group, and 77.63% and 72.37% in LL group respectively (χ²=1.536, 2.156, P=0.863, 0.698).

There is no difference in the efficacy and prognosis between low ligation of inferior mesenteric artery and high ligation surgery in laparoscopic resection of rectal cancer. Compared with high ligation surgery, the incidence of anastomotic leakage is lower while other perioperative indicators were the same in low ligation surgery. Therefore, low ligation of inferior mesenteric artery with No.3 central lymph node dissection is worth promoting.