Retrospective analysis of IMA ligation level effects on nodal dissection and anastomosis in colorectal cancer

Abstract This study compared the outcomes of high versus low inferior mesenteric artery (IMA) ligation in 380 patients undergoing surgery for rectal or sigmoid colon cancer, with intraoperative indocyanine green (ICG) fluorescence angiography used to assess anastomotic perfusion. The high ligation g...

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Main Authors: Daqing Cheng, Yunpeng Zhang, Qunjun Lin, Ming Xu, Jue Wang, Peng Sun, Bo Han
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-10944-9
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author Daqing Cheng
Yunpeng Zhang
Qunjun Lin
Ming Xu
Jue Wang
Peng Sun
Bo Han
author_facet Daqing Cheng
Yunpeng Zhang
Qunjun Lin
Ming Xu
Jue Wang
Peng Sun
Bo Han
author_sort Daqing Cheng
collection DOAJ
description Abstract This study compared the outcomes of high versus low inferior mesenteric artery (IMA) ligation in 380 patients undergoing surgery for rectal or sigmoid colon cancer, with intraoperative indocyanine green (ICG) fluorescence angiography used to assess anastomotic perfusion. The high ligation group demonstrated significantly greater lymph node yield (13 vs.12 p < 0.001) and was associated with more advanced T/N stages, while operative time was longer (218 ± 45 vs. 189 ± 38 min, p < 0.001). ICG navigation enabled objective blood supply evaluation, resulting in no ischemia-related anastomotic leaks and comparable overall complication rates (3.1% vs. 3.4%, p = 0.82). These findings highlight that high ligation improves oncologic resection completeness through extended lymphadenectomy, whereas ICG fluorescence technology enhances anastomotic safety by providing real-time perfusion assessment, offering a dual advantage in colorectal cancer surgery.
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spelling doaj-art-a54f72dd58cf4ec18e8ab1aaa3d27ab12025-08-20T03:46:07ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-10944-9Retrospective analysis of IMA ligation level effects on nodal dissection and anastomosis in colorectal cancerDaqing Cheng0Yunpeng Zhang1Qunjun Lin2Ming Xu3Jue Wang4Peng Sun5Bo Han6Department of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of MedicineAbstract This study compared the outcomes of high versus low inferior mesenteric artery (IMA) ligation in 380 patients undergoing surgery for rectal or sigmoid colon cancer, with intraoperative indocyanine green (ICG) fluorescence angiography used to assess anastomotic perfusion. The high ligation group demonstrated significantly greater lymph node yield (13 vs.12 p < 0.001) and was associated with more advanced T/N stages, while operative time was longer (218 ± 45 vs. 189 ± 38 min, p < 0.001). ICG navigation enabled objective blood supply evaluation, resulting in no ischemia-related anastomotic leaks and comparable overall complication rates (3.1% vs. 3.4%, p = 0.82). These findings highlight that high ligation improves oncologic resection completeness through extended lymphadenectomy, whereas ICG fluorescence technology enhances anastomotic safety by providing real-time perfusion assessment, offering a dual advantage in colorectal cancer surgery.https://doi.org/10.1038/s41598-025-10944-9
spellingShingle Daqing Cheng
Yunpeng Zhang
Qunjun Lin
Ming Xu
Jue Wang
Peng Sun
Bo Han
Retrospective analysis of IMA ligation level effects on nodal dissection and anastomosis in colorectal cancer
Scientific Reports
title Retrospective analysis of IMA ligation level effects on nodal dissection and anastomosis in colorectal cancer
title_full Retrospective analysis of IMA ligation level effects on nodal dissection and anastomosis in colorectal cancer
title_fullStr Retrospective analysis of IMA ligation level effects on nodal dissection and anastomosis in colorectal cancer
title_full_unstemmed Retrospective analysis of IMA ligation level effects on nodal dissection and anastomosis in colorectal cancer
title_short Retrospective analysis of IMA ligation level effects on nodal dissection and anastomosis in colorectal cancer
title_sort retrospective analysis of ima ligation level effects on nodal dissection and anastomosis in colorectal cancer
url https://doi.org/10.1038/s41598-025-10944-9
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