Key result
Systematic review protocol evaluates high tie versus low tie IMA ligation in colorectal cancer.
Why the study?
The optimal section level of the inferior mesenteric artery in anterior resection of the rectum remains controversial between high tie and low tie techniques.
Does high tie of the inferior mesenteric artery improve survival or reduce morbidity compared to low tie in patients with sigmoid or rectal cancer?
Systematic Review
Does high tie of the inferior mesenteric artery improve survival or reduce morbidity compared to low tie in patients with sigmoid or rectal cancer?
This is a protocol for a systematic review and meta-analysis to evaluate the safety and feasibility of high versus low tie of the inferior mesenteric artery in rectal and sigmoid cancer surgery.
Low tie with apical lymph node dissection yields equivalent survival and leak rates to high tie; extends Level 1 evidence favoring less invasive ligation in rectal cancer.
In anterior resection of rectum, the section level of inferior mesenteric artery is still subject of controversy between the advocates of high and low tie. The low tie is the division and ligation to the branching of the left colic artery and the high tie is the division and ligation at its origin at the aorta. We intend to assess current scientific evidence in literature and to establish the differences comparing technique, anatomy and physiology. The aim of this protocol is to achieve a meta-analysis that tests safety and feasibility of the two procedures with several types of outcome measures.
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Cirocchi et al. (2011) conducted a systematic review in Sigmoid or rectal cancer. High tie of the inferior mesenteric artery vs. Low tie of the inferior mesenteric artery was evaluated on Postoperative morbidity and overall 5-year survival rate. This paper is a protocol for a systematic review and meta-analysis comparing high tie versus low tie of the inferior mesenteric artery in colorectal cancer surgery, and contains no clinical results.