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En-Bloc Excision of the High-ligated Inferior Mesenteric Vein Pedicle With the Specimen in Patients Undergoing Minimally Invasive and Open Sphincter Saving Rectal Resections for Cancer

Bilgin, Ismail Ahmet MD*; Aytaç, Erman MD, FTBS, EBSQ-c, FASCRS*; Baca, Bilgi MD, FTBS, EBSQ-c*; Benlice, Çigdem MD; Aghayeva, Afag MD*; Esen, Eren MD*; Göksel, Süha MD; Tayfun, Karahasanog[Combining Breve]lu MD*; Hamzaoglu, Ismail MD*

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: February 2019 - Volume 29 - Issue 1 - p 13–17
doi: 10.1097/SLE.0000000000000615
Original Articles

Although high-ligated pedicle of the inferior mesenteric artery is usually kept in the resected specimens, the value of preserving high-ligated pedicle of the inferior mesenteric vein within the resected specimens of the sphincter saving rectal resections for cancer is not well defined. In the current study, patients undergoing open, laparoscopic, and robotic sphincter saving rectal resection for cancer were prospectively included. Lymph node invasion and presence of lymph nodes along the IMV pedicles were analyzed. In total 100 patients were included. There were lymph nodes in 63 patients at the IMV and 71 patients at the IMA pedicles. En-bloc removal of the high-ligated IMV pedicle with the resected specimen significantly increased the number of harvested lymph nodes(P<0.001) regardless of surgical modality (P=0.36). Although it increases the number of harvested lymph nodes with acceptable operative morbidity, no oncological benefits were found related to preservation of high-ligated pedicle of the inferior mesenteric vein within the resected specimen of the rectum.

Departments of *General Surgery

Pathology, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey

Department of General Surgery, Cleveland Clinic, OH

I.A.B., E.A., B.B., K.T., I.H.: study conception and design. I.A.B., Ç.B., A.A., S.G.: acquisition of data. I.A.B., E.A., E.E.: analysis and interpretation of data.

The authors declare no conflicts of interest.

Reprints: Ismail Hamzaoglu, MD, Department of General Surgery, Acibadem Mehmet Ali Aydinlar University School of Medicine. Darüşşafaka Mahallesi, Büyükdere Cd No. 40, 34457 Sariyer, Istanbul, Turkey (e-mail:

Received August 8, 2018

Accepted November 13, 2018

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