Preserving the superior rectal artery in laparoscopic sigmoid resection for XXXX .

@entity1 @entity834 @entity322 @entity190 @entity254 @entity547 @entity1142 @entity3577
Sigmoid resection is indicated in the treatment of @entity3577 ( @entity3577 ) in @entity1 with prolonged colorectal transit time (CTT). Its use, however, has been limited because of fear of @entity834 . This study challenges the current practice of dividing the mesorectum by prospectively evaluating the impact of sparing the superior rectal artery (SRA) on leak rates after laparoscopic sigmoid resection (LSR) for @entity3577 . During a 30-month period, data on 33 selected @entity1 with @entity3577 were prospectively collected. Three @entity1 were withdrawn from the analysis, as they had neither resection nor @entity254 . Twenty-nine @entity1 and 1 @entity1 (median age 55 range 21-83 years) underwent LSR with preservation of SRA for a median @entity3577 of 8 (3-15) cm. There were 20 ASA I and 10 ASA II @entity1 . Ten @entity1 had undergone previous surgery. Four @entity1 complained of @entity1142 , whereas @entity322 was present in 26 @entity1 . Anal ultrasound showed isolated internal sphincter defects in 2 @entity1 . Four young adults (21-32 years) had normal CTT, whereas 26 older @entity1 had a median CTT of 5(4-6) days. Defecography demonstrated 10 enteroceles, two sigmoidoceles, and one @entity547 through the levator ani muscle. Mortality was nil. Median operating room time was 180 (120-330) min, suprapubic incision length 5(3-7) cm, estimated @entity190 150 (50-500) mL, specimen length 20 (12-45) cm, solid food resumption 3(1-6) days, and length of stay 4.5(2-7) days. Thirty-day complications were not related to anastomosing and occurred in 20% of the @entity1 . Median follow-up was 34.1 (18-48) months. One @entity1 had a recurrence. Although the evidence provided by the present study suggests that sparing SRA has a favorable impact on @entity834 rates, these nonrandomized results need further evaluation. The division of the mesorectum at the rectosigmoid junction seems not necessary, and its sparing should therefore be considered as it may contain @entity834 rates.
