Trial reportInternational journal of colorectal disease2011
High tie versus low tie in rectal surgery: comparison of anastomotic perfusion.
Trial report in International journal of colorectal disease, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 55 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 7 syntheses or guidelines pooled it, 115 citations in OpenAlex.
- Pooled it
- Brazilian Society of Surgical Oncology: Guidelines for the Lymphadenectomy in Colorectal Cancer.Journal of surgical oncology · 2025Guideline
- Inferior mesenteric artery ligation level in rectal cancer surgery: still no answer-a systematic review and meta-analysis.Langenbeck's archives of surgery · 2023Pooled it
- High Versus Low Ligation of the Inferior Mesenteric Artery in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2022Pooled it
- Lymph node yield, survival benefit, and safety of high and low ligation of the inferior mesenteric artery in colorectal cancer surgery: a systematic review and meta-analysis.International journal of colorectal disease · 2019Pooled it
- Preservation versus non-preservation of left colic artery in colorectal cancer surgery: An updated systematic review and meta-analysis.Medicine · 2019Pooled it
- High ligation of the inferior mesenteric artery during sigmoid colon and rectal cancer surgery increases the risk of anastomotic leakage: a meta-analysis.World journal of surgical oncology · 2018Pooled it
- ArtiSential® vs. straight-stick in laparoscopic left-sided colorectal resection: a prospective randomized study.Surgical endoscopy · 2026Trial
- Effects of mesenteric artery ligation level on patients with locally advanced rectal cancer after neoadjuvant chemoradiotherapy: a retrospective cohort study.Techniques in coloproctology · 2024Trial
- Short-term and long-term results of a randomized study comparing high tie and low tie inferior mesenteric artery ligation in laparoscopic rectal anterior resection: subanalysis of the HTLT (High tie vs. low tie) study.Surgical endoscopy · 2019Trial
- Trial
- The application of intraoperative strategies to reduce protective stoma in mid and low rectal cancer: a retrospective study utilizing indocyanine green and precise anatomical techniques.World journal of surgical oncology · 2026Article
- High versus low ligation of the inferior mesenteric artery during transanal total mesorectal excision for low rectal cancer: impact on postoperative anastomotic leakage.Frontiers in oncology · 2026Article
- Laser speckle contrast imaging for real-time quantification of colonic perfusion following high versus low tie in anterior rectal resection surgery: a pilot prospective study.International journal of surgery (London, England) · 2026Article
- Modification of the vascular preparation after high tie ligation to improve colonic perfusion and increase the length of the colon limb in low anterior rectal resection.Surgical endoscopy · 2025Article
- Article
- Efficacy of lymph node dissection around the inferior mesenteric artery with preservation of the left colic artery for rectal cancer.Annals of gastroenterological surgery · 2025Article
- Comparison of short-term surgical outcomes between high and low tie ligation of the inferior mesenteric artery in robotic rectal cancer surgery: a propensity score matching analysis.Journal of robotic surgery · 2025Article
- Short-term outcomes of vessel-oriented D2 and D3 lymph node dissection for sigmoid colon cancer.Techniques in coloproctology · 2024Article
- Quantification of indocyanine-green-enhanced fluorescence with spectrophotometry (O2C®) in low anterior rectal resection: A prospective study.Techniques in coloproctology · 2024Observational
Corrections and comments
- Erratum issuedGosselink, Martijn [corrected to Gosselink, Martijn P]
Authors and funding
15 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeBoth "high tie" (HT) and "low tie" (LT) are well-known strategies in rectal surgery. The aim of this study was to compare colonic perfusion after HT to colonic perfusion after LT.
methodsPatients undergoing rectal resection for malignancy were included. Colonic perfusion was measured with laser Doppler flowmetry, immediately after laparotomy on the antimesenterial side of the colon segment that was to become the afferent loop (measurement A). This measurement was repeated after rectal resection (measurement B). The blood flow ratios (B/A) were compared between the HT group and the LT group.
resultsBlood flow was measured in 33 patients, 16 undergoing HT and 17 undergoing LT. Colonic blood flow slightly decreased in the HT group whereas the flow increased in the LT group. The blood flow ratio was significantly higher in the LT group (1.48 vs. 0.91; p = 0.04), independent of the blood pressure.
conclusionThis study shows the blood flow ratio to be higher in the LT group. This suggests that anastomoses may benefit from better perfusion when LT is performed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.