Аннотация

Цель
To evaluate the efficacy and safety of robot-assisted low anterior rectal resections with different levels of inferior mesenteric artery ligation.
Материал и методы
A retrospective study was conducted on 91 patients who underwent robot-assisted surgery at the Belarusian State Medical University Clinic (2022–2024). Robot-assisted interventions were performed using the da Vinci Si and da Vinci Xi surgical systems. Perioperative and early postoperative outcomes were compared in two groups of patients: high inferior mesenteric artery ligation (55 patients) and low inferior mesenteric artery ligation (36 patients). The mean patient age was 63.4 ± 9.4 years; there were 39 men (43.5%) and 52 women (56.5%).
Результаты
Preservation of the left colic artery did not increase the duration of the operation (221.86 ± 63.64 minutes in the group with high ligation of the inferior mesenteric artery and 205.27 ± 45.70 minutes in the group with low ligation, however, the differences did not reach the level of statistical significance (p = 0.68), accompanied by a lower incidence of complications and a reduction in hospitalization (the average duration of hospitalization was 10.5 ± 3.74 days in the group with high ligation of the IMA and 8.9 ± 3.63 days with low ligation) compared with the group of patients with a high level of ligation of the inferior mesenteric artery. In the structure of complications of the early postoperative period: failure of the colorectal anastomosis occurred in 2 (3.5%) cases in the group with high ligation of the artery and 1 (2.7%) in the group with low ligation (p = 0.75)
Заключение
Vascular-preserving tactics in robot-assisted rectal interventions are safe and promising. This approach reduces surgical time by eliminating the need to mobilize the splenic flexure of the colon to form the anastomosis. However, a more detailed study of the anastomotic zone perfusion in the early postoperative period is required to assess the impact of this approach on the risk of anastomotic leakage, the main complication of such surgeries.

Ключевые слова

colorectal cancer robotic-assisted surgery inferior mesenteric artery left colic artery low anterior resection

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Список литературы

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