PP 02. High Ligation Of The Inferior Mesenteric Artery In Rectal Cancer Surgery

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J. Hida, T. Yoshifuji, T. Tokoro, K. Ueda, K. Daito, F. Sugiura, Y. Yoshioka, K. Okuno, A Kogita

18:16 - 18:22h at Margrit Room

Categories: Gastrointestinal Surgery, Poster Session

Session: Poster (P1) - Gastrointestinal Surgery

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Background
In surgery for rectal cancer, it is unclear whether the inferior mesenteric artery (IMA) should be ligated at a high or low position. The study contained herein was undertaken to clarify the indications for high ligation of the IMA.

Material and Methods
Subjects included 198 patients with rectal cancer who underwent resection with high ligation of the IMA. Nodal metastases were examined by the clearing method.

Result
The incidence of metastases to the lymph nodes surrounding the origin of the IMA (root nodes) was 8.6%. IMA root nodal metastases occurred more frequently with pT3 and pT4 cancer. The 5-year survival rate in patients with IMA root nodal metastases was 38.5%; this rate was significantly lower than in those without IMA root nodal metastases (73.4%).

Conclusion
Although the prognosis for 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. Until a definitive answer is available we will continue to perform a high ligation of the IMA, not only in the hope of improved survival but for more accurate staging and as an easier operative procedure.