文章：

直肠癌手术中肠系膜下动脉结扎水平的超越常规探讨：综述

Inferior Mesenteric Artery Ligation Level in Rectal Cancer Surgery beyond Conventions: A Review

原文发布日期：22 December 2023

DOI: 10.3390/cancers16010072

类型: Article

开放获取: 是

英文摘要：

Within the intricate field of rectal cancer surgery, the contentious debate over the optimal level of ligation of the inferior mesenteric artery (IMA) persists as an ongoing discussion, influencing surgical approaches and patient outcomes. This narrative review incorporates historical perspectives, technical considerations, and functional as well as oncological outcomes, addressing key questions related to anastomotic leakage risks, genitourinary function, and oncological concerns, providing a more critical understanding of the well-known inconclusive evidence. Beyond the dichotomy of high versus low tie, it navigates the complexities of colorectal cancer surgery with a fresh perspective, posing a transformative question: “Is low tie ligation truly reproducible?” Considering a multidimensional approach that enhances patient outcomes by integrating the surgeon, patient, technique, and technology, instead of a rigid and categorical statement, we argued that a balanced response to this challenging question may require compromise.

摘要翻译： 

在直肠癌手术这一复杂领域内，关于肠系膜下动脉（IMA）最佳结扎水平的争议性讨论持续影响着手术方式选择及患者预后。本叙述性综述融合历史视角、技术考量以及功能与肿瘤学结局，针对吻合口漏风险、泌尿生殖功能及肿瘤学相关问题展开探讨，对现有未形成定论的证据提出了更具批判性的理解。超越高位与低位结扎的二元对立，本文以全新视角剖析结直肠癌手术的复杂性，提出一个具有变革意义的问题：“低位结扎是否真正具备可重复性？”通过整合外科医生、患者、技术及科技等多维度要素以改善患者预后的综合考量，我们认为对这一复杂问题的平衡解答可能需要采取折衷方案，而非固守僵化的绝对论断。

原文链接：

Inferior Mesenteric Artery Ligation Level in Rectal Cancer Surgery beyond Conventions: A Review