지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.97 No.5
- 발행연도
- 2019.11
- 수록면
- 254 - 260 (7page)
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초록· 키워드
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Purpose: To compare high and low inferior mesenteric artery (IMA) ligation in a large number of patients, and investigate the short-term and long-term outcomes.
Methods: This retrospective study compared outcomes between high IMA ligation and low IMA ligation with dissection of lymph nodes (LNs) around the IMA origin. A total of 1,213 patients underwent elective low anterior resection with double-stapling anastomosis for stage I–III rectal cancer located ≥6 cm from the anal verge (835 patients underwent IMA ligation at the IMA origin; 378 patients underwent IMA ligation directly distal to the root of the left colic artery along with dissection of LNs around the IMA origin).
Results: There was no difference in anastomotic leakage rate between groups. The 2 groups did not significantly differ in intraoperative blood loss, perioperative complications, total number of harvested LNs, and metastatic IMA LNs. However, more metastatic LNs were harvested in the high-tie than in the low-tie group (1.3 ± 2.9 vs. 0.8 ± 1.9, P = 0.002), and the incidence of positive pathologic nodal status was higher in the high-tie group (37.9% vs. 28.6%, P = 0.001). The 5-year local recurrence-free and metastasis-free survival rates were similar between groups, as were the 5-year overall and cancer-specific survival rates.
Conclusion: Low IMA ligation with dissection of LNs around the IMA origin showed no differences in anastomotic leakage rate compared with high IMA ligation, without affecting oncologic outcomes. High IMA ligation did not seem to increase the number of total harvested LNs, whereas the ratio of metastatic apical LNs were similar between groups.
Methods: This retrospective study compared outcomes between high IMA ligation and low IMA ligation with dissection of lymph nodes (LNs) around the IMA origin. A total of 1,213 patients underwent elective low anterior resection with double-stapling anastomosis for stage I–III rectal cancer located ≥6 cm from the anal verge (835 patients underwent IMA ligation at the IMA origin; 378 patients underwent IMA ligation directly distal to the root of the left colic artery along with dissection of LNs around the IMA origin).
Results: There was no difference in anastomotic leakage rate between groups. The 2 groups did not significantly differ in intraoperative blood loss, perioperative complications, total number of harvested LNs, and metastatic IMA LNs. However, more metastatic LNs were harvested in the high-tie than in the low-tie group (1.3 ± 2.9 vs. 0.8 ± 1.9, P = 0.002), and the incidence of positive pathologic nodal status was higher in the high-tie group (37.9% vs. 28.6%, P = 0.001). The 5-year local recurrence-free and metastasis-free survival rates were similar between groups, as were the 5-year overall and cancer-specific survival rates.
Conclusion: Low IMA ligation with dissection of LNs around the IMA origin showed no differences in anastomotic leakage rate compared with high IMA ligation, without affecting oncologic outcomes. High IMA ligation did not seem to increase the number of total harvested LNs, whereas the ratio of metastatic apical LNs were similar between groups.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
Beahrs OH / 1992 / Staging of cancer of the colon and rectum / Cancer 70(5 Suppl):1393~1396
Sugarbaker PH / 1982 / Influence of surgical techniques on survival in patients with colorectal cancer / Dis Colon Rectum 25:545~557
Cirocchi R / 2012 / High tie versus low tie of the inferior mesenteric artery in colorectal cancer : a RCT is needed / Surg Oncol 21:e111~e123
Hida J / 2013 / High ligation of the inferior mesenteric artery in rectal cancer surgery / Surg Today 43:8~19
Lange MM / 2008 / Level of arterial ligation in rectal cancer surgery: low tie preferred over high tie. A review / Dis Colon Rectum 51:1139~1145
Sugarbaker PH / 1982 / Influence of surgical techniques on survival in patients with colorectal cancer / Dis Colon Rectum 25:545~557
Cirocchi R / 2012 / High tie versus low tie of the inferior mesenteric artery in colorectal cancer : a RCT is needed / Surg Oncol 21:e111~e123
Hida J / 2013 / High ligation of the inferior mesenteric artery in rectal cancer surgery / Surg Today 43:8~19
Lange MM / 2008 / Level of arterial ligation in rectal cancer surgery: low tie preferred over high tie. A review / Dis Colon Rectum 51:1139~1145
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UCI(KEPA) : I410-ECN-0101-2019-514-001293881