关键词: 直肠癌, 腹腔镜, 左结肠动脉, 肠系膜下动脉, 淋巴结

Abstract: Critical considerations for preserving the left colic artery and dissecting No. 253 lymph nodes in laparoscopic resection of rectal cancer        LI Xin-xiang, YANG Yu-fei. Department of Colorectal Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Corresponding author: LI Xin-Xiang, E-mail:lxx1149@163.com
Abstract    While ongoing debate has persisted regarding the management of the left colic artery in laparoscopic resection of reatal cancer, recent years have witnessed a gradual shift towards the surgical approach that emphasizes the preservation of the left colic artery and thorough dissection of the No.253 lymph node as the prevailing method. With the concept of "the lymph nodes in the triangular domain of inferior mesenteric artery", the approach “vessel-centered laparoscopic total mesorectal excision”was introduces. This approach advocates prioritizing the veins before arteries and addressing layers after vessels. It aligns more closely with the principles of oncological radical surgery, contributing to enhanced vascular anatomy comprehension, efficient lymph node dissection, and the preservation of the left colic artery. Once the surgical process has been standardized, it significantly reduces the duration of the procedure. Preserving the left colic artery not only maximizes blood supply preservation at the anastomotic site but also protects the nerves within the mesorectal area, offering the potential to mitigate postoperative complications among patients.

Key words: rectal neoplasms, laparoscopes, left colic artery, inferior mesenteric artery, lymph nodes