Trial reportSurgical endoscopy2019
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.
Trial report in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 5 of them syntheses that pooled it.
What it found
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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
38 citing papers in PubMed, 5 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Pooled it
- Low Versus High Ligation of Inferior Mesenteric Artery in Rectal and Sigmoid Cancers: A Systematic Review, Meta-analysis, and Trial Sequential Analysis of Randomized Controlled Trials.Annals of surgical oncology · 2026Pooled it
- Pooled it
- 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
- 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
- Impact on defecatory, urinary and sexual function after high-tie sigmoidectomy: a post-hoc analysis of a multicenter randomized controlled trial comparing extended versus standard complete mesocolon excision.Langenbeck's archives of surgery · 2023Trial
- Quantitative evaluation of colon perfusion after high versus low ligation in rectal surgery by indocyanine green: a pilot study.Surgical endoscopy · 2022Trial
- Trial
- ASO Author Reflections: Low Ligation, High Impact: When Less is More in Recto-Sigmoid Cancer.Annals of surgical oncology · 2026Article
- Retrospective analysis of IMA ligation level effects on nodal dissection and anastomosis in colorectal cancer.Scientific reports · 2025Article
- Short-term outcomes of vessel-oriented D2 and D3 lymph node dissection for sigmoid colon cancer.Techniques in coloproctology · 2024Article
- Construction of a nomogram based on clinicopathologic features to predict the likelihood of No. 253 lymph node metastasis in rectal cancer patients.Langenbeck's archives of surgery · 2024Article
- A nomogram for predicting lymph nodes metastasis at the inferior mesenteric artery in rectal cancer: a retrospective case-control study.Updates in surgery · 2024Article
- The Atlas of the Inferior Mesenteric Artery and Vein under Maximum-Intensity Projection and Three-Dimensional Reconstruction View.Journal of clinical medicine · 2024Article
- To go high, or to go low: the never-ending debate of inferior mesenteric artery ligation.Annals of coloproctology · 2024Article
- Inferior Mesenteric Artery Ligation Level in Rectal Cancer Surgery beyond Conventions: A Review.Cancers · 2023Review
- Efficacy of left colic artery preservation with D3 lymph node dissection in laparoscopic surgery for advanced sigmoid and rectal cancer.Surgery today · 2023Article
- Comparison of the short-term and long-term outcomes of three different types of inferior mesenteric artery ligation in left colonic and rectal cancers: a network meta-analysis.Updates in surgery · 2023Review
- Surgical considerations for the "perfect" colorectal anastomosis.Journal of gastrointestinal oncology · 2023Review
- Potential short-term outcome advantage of low vs. high ligation of inferior mesenteric artery for sigmoid and rectal cancer: propensity score matching analysis.BMC surgery · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn rectal anterior resection, a clear consensus regarding the optimal level of inferior mesenteric artery (IMA) ligation does not exist because of a lack of randomized trials. We conducted a randomized trial to determine if the IMA should be tied at the origin (high tie, HT) or distal to the left colic artery (low tie, LT) (HTLT study). This study is a subanalysis of HTLT study for laparoscopic surgery.
methodsAll candidates were randomly divided into the HT or LT groups. The lymph node dissection around the origin of the IMA was performed in the LT group. The stratified factor was the approach (open or laparoscopy). Evaluation parameters were operative factors, short-term and long-term results. In the present study, laparoscopic surgeries were examined as subgroup analysis.
resultsFrom June 2006 to September 2012, 331 patients were registered. Two hundred and fifteen patients (107 for HT: 108 for LT) underwent laparoscopic surgeries. There was no difference between the groups in background. The incidence of anastomotic leakage (HT: LT %) showed no significant differences for grade 2 or higher (11.2:9.3), and grade 3 or higher (2.8:4.6). There were no differences in operative time (200:205 min), blood loss (15:15 ml), number of dissected lymph nodes (22:20), and postoperative hospital stay (10:10 days). The incidence of bowel obstruction in HT was significant (3.7 vs. 0%, p = 0.043). There were no significant differences in overall survival (5-year: 91.3 vs. 90.2%, p = 0.850) and disease-free survival (5-year: 83.2 vs. 78.0%, p = 0.525). There were no differences in the first recurrent site and death reason between both groups. The risk factors for leakage were being male and an anastomotic level in a multivariate analysis by logistic regression.
conclusionThe IMA ligation level was unrelated to anastomotic leakage. No significant difference was detected in long-term results between HT and LT.
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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.