Comparison of laparoscopic sigmoidectomy with and without preservation of the superior rectal artery: a single-institution retrospective study.

Introduction: The inferior mesenteric artery is usually divided during the resection of sigmoid colon cancers. However, this sometimes results in an insufficient blood supply to the anastomosis, leading to anastomotic leakage. We conducted a retrospective analysis to determine the feasibility and potential benefits of preserving the superior rectal artery (SRA).

Methods: Fifty-seven patients underwent SRA-preserving sigmoidectomy with D2 or D3 lymph node dissection (group A) between June 2008 and May 2012. These patients were compared with 35 patients who underwent sigmoidectomy without preservation of the SRA (group B) during the same period.

Results: The amount of blood loss, the number of harvested lymph nodes, and the postoperative morbidity rate did not differ significantly between the groups. There were no cases of anastomotic leakage in group A and there was one in group B, but this difference was not significant. The 3-year relapse-free survival rates also did not differ significantly between the two groups, irrespective of lymph node status.

Conclusion: Sigmoidectomy with SRA preservation can be performed without compromising the quality of lymph node dissection and relapse-free survival. No advantage of preserving the SRA could be demonstrated, but it is noteworthy that no anastomotic leakage was noted among the 57 patients in group A.