Should we preserve superior rectal artery for safe rectal anastomosis?

Objectives: purpose of this study is short term evaluation of the Competence of sparing of superior rectal artery in descending and sigmoid colon malignancy radical resection. Background: There is a debate whether preservation of superior rectal artery has value in improving rectal anastomosis without affecting lymph node harvest in left sided colon cancer resection. Methods: It is a prospective study conducted in surgery department Menoufia University. Operable Fifty cases with malignancy of descending colon and sigmoid operated with sigmoidectomy or radical excision of descending colon. From April 2021 to April 2023 were included. In preservation group (25 patients), lymphatic tissue at inferior mesenteric artery origin was cleared while preserving superior rectal artery. In control group of 25 patients we ligated inferior mesenteric artery at its root. Pathological evaluation to the specimen was done to detect lymph node harvest in each group. Post-operative follow up of the patients for intestinal leak. Results: In this study, the operative time till exteriorization of specimen was slightly longer in superior rectal artery preservation group than non-preservation group (p =0.0190.05)). Lymph node harvest between two groups (P =0.674(>0.05), showed no statistical difference. Conclusion: Sparing superior rectal artery improves colorectal anastomosis blood supply without affecting lymphatic dissection, so decreasing risk of intestinal leak without affecting lymph node harvest.