Influence of the ligation sequence of the inferior mesenteric artery and vein on circulating tumor cells in laparoscopic rectal cancer surgery: a prospective pilot study

Both A-first and V-first ligation sequences are viable and safe options in laparoscopic rectal cancer surgery. The V-first approach may be more effective in reducing levels of CTCs in peripheral blood. Further randomized studies are warranted to explore these findings comprehensively.