SynthesisMedicine2017
The long-term survival benefits of high and low ligation of inferior mesenteric artery in colorectal cancer surgery: A review and meta-analysis.
Synthesis in Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 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
25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Pooled 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
- Trial
- Clinical implications of lactylation modification in digestive system tumors (Review).Oncology letters · 2026Review
- 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
- Short-term outcomes of vessel-oriented D2 and D3 lymph node dissection for sigmoid colon cancer.Techniques in coloproctology · 2024Article
- Long-term clinical outcomes after high and low ligations with lymph node dissection around the root of the inferior mesenteric artery in patients with rectal cancer.Annals of coloproctology · 2024Article
- Efficacy of left colic artery preservation with D3 lymph node dissection in laparoscopic surgery for advanced sigmoid and rectal cancer.Surgery today · 2023Article
- Lymphadenectomy with venation is preferred compared to skeletonization for patients with rectal and sigmoid colon cancer: a retrospective cohort study.Journal of gastrointestinal oncology · 2022Article
- Apical lymphadenectomy during low ligation of the IMA during rectosigmoid resection for cancer.Surgery open science · 2021Article
- Analysis of risk factors and prognosis of 253 lymph node metastasis in colorectal cancer patients.BMC surgery · 2021Article
- Therapeutic significance of D3 dissection for low rectal cancer: a comparison of dissections between the lateral pelvic lymph nodes and the lymph nodes along the root of the inferior mesenteric artery in a multicenter retrospective cohort study.International journal of colorectal disease · 2021Article
- Pathological features of lymph nodes around inferior mesenteric artery in rectal cancer: a retrospective study.World journal of surgical oncology · 2021Article
- The effect of different inferior mesenteric artery ligation levels and different lymph node dissection areas on the short- and long-term outcomes of rectal cancer.Journal of gastrointestinal oncology · 2021Article
- Clinical and oncological outcomes of the low ligation of the inferior mesenteric artery with robotic surgery in patients with rectal cancer following neoadjuvant chemoradiotherapyTurkish journal of medical sciences · 2021Article
- An Intrasheath Separation Technique for Nerve-Sparing High Ligation of the Inferior Mesenteric Artery in Colorectal Cancer Surgery.Frontiers in oncology · 2021Article
- Anatomical study of the left colic artery in laparoscopic-assisted colorectal surgery.Surgical endoscopy · 2020Article
- High Versus Low Ligation of the Inferior Mesenteric Artery During Rectal Resection for Cancer: Oncological Outcomes After Three Years of Follow-Up From the HIGHLOW Trial.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe decision of ligation at the origin of the inferior mesenteric artery (IMA) or below the origin of the left colic artery (LCA) has remained a dilemma for surgeons in colorectal cancer surgery. The available studies are controversial. The objective of this meta-analysis is to compare the predictive significance of high versus low ligation in colorectal cancer surgery.
methodsA literature search done using Medline, EMBASE, GoogleScholar, and references. A meta-analysis was performed to analyze the 5-year overall survival (OS) of the high and low ligation using hazard ratio (HR) and 95% confidence interval (CI). We further analyzed 2 subgroups considering the level of lymph nodes (LNs) extension. That is IMA positive (+ve) and negative (-ve) LNs. Survival differences were analyzed.
resultsA total of 3119 patients in 5 cohorts were included in this meta-analysis. The pooled HR results showed significant OS benefit of high ligation than low ligation (HR; 0.77, 95% CI: 0.66-0.89) in the "IMA +ve" group with 33% decreased risk, while there is no statistical significance in the "IMA -ve" (HR 0.66, 95% CI: 0.30-1.46) and the "all cases" group (HR 0.69, 95% CI: 0.41-1.15).
conclusionThe pooled data showed high ligation of IMA has a better survival benefit for the patients with IMA positive LNs. It signifies high ligation should be recommended for the advanced cases or with the suspected high risk of IMA lymphatic metastasis. The limited number of articles demands future high-powered, well-designed randomized controlled trials (RCTs) for the further reliable conclusion.
Indexed as
Identifiers
What OpenQuestion holds
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.