Left colic artery–preserving radical rectal cancer surgery: a literature review

When meticulous D3 lymph-node clearance is maintained, LCA preservation delivers oncologic outcomes equivalent to high-tie ligation while offering notable advantages in peri-operative safety and long-term function. Consequently, low-tie LCA-preserving resection should be considered the preferred approach for most low-anterior resections unless specific anatomic or oncologic contraindications exist. Future multicentre randomised trials and AI-assisted studies are warranted to identify high-risk subgroups and optimise patient-specific indications.