| Autor: |
Brillantino A; Department of Surgery, 'A. Cardarelli' Hospital, Via A. Cardarelli 9, 80131 Naples, Italy., Skokowski J; Department of Medicine, Academy of Applied Medical and Social Sciences-AMiSNS: Akademia Medycznych I Spolecznych Nauk Stosowanych-2 Lotnicza Street, 82-300 Elbląg, Poland.; Department of General Surgery and Surgical Oncology, 'Saint Wojciech' Hospital, 'Nicolaus Copernicus' Health Center, Jana Pawła II 50, 80-462 Gdańsk, Poland., Ciarleglio FA; Department of General Surgery and Hepato-Pancreato-Biliary (HPB) Unit-APSS, 38121 Trento, Italy., Vashist Y; Department Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia., Grillo M; Department of Surgery, 'A. Cardarelli' Hospital, Via A. Cardarelli 9, 80131 Naples, Italy., Antropoli C; Department of Surgery, 'A. Cardarelli' Hospital, Via A. Cardarelli 9, 80131 Naples, Italy., Herrera Kok JH; Department of General and Digestive Surgery-Upper GI Unit, University Hospital of León, 24008 León, Spain., Mosca V; Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', 80138 Napoli, Italy., De Luca R; Department of Surgical Oncology, IRCCS Istituto Tumori 'Giovanni Paolo II', 70124 Bari, Italy., Polom K; Department of Medicine, Academy of Applied Medical and Social Sciences-AMiSNS: Akademia Medycznych I Spolecznych Nauk Stosowanych-2 Lotnicza Street, 82-300 Elbląg, Poland.; Department of Gastrointestinal Surgical Oncology, Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland., Talento P; Department of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio Emilia, 42122 Reggio Emilia, Italy., Marano L; Department of Medicine, Academy of Applied Medical and Social Sciences-AMiSNS: Akademia Medycznych I Spolecznych Nauk Stosowanych-2 Lotnicza Street, 82-300 Elbląg, Poland.; Department of General Surgery and Surgical Oncology, 'Saint Wojciech' Hospital, 'Nicolaus Copernicus' Health Center, Jana Pawła II 50, 80-462 Gdańsk, Poland. |
| Abstrakt: |
Within the intricate field of rectal cancer surgery, the contentious debate over the optimal level of ligation of the inferior mesenteric artery (IMA) persists as an ongoing discussion, influencing surgical approaches and patient outcomes. This narrative review incorporates historical perspectives, technical considerations, and functional as well as oncological outcomes, addressing key questions related to anastomotic leakage risks, genitourinary function, and oncological concerns, providing a more critical understanding of the well-known inconclusive evidence. Beyond the dichotomy of high versus low tie, it navigates the complexities of colorectal cancer surgery with a fresh perspective, posing a transformative question: "Is low tie ligation truly reproducible?" Considering a multidimensional approach that enhances patient outcomes by integrating the surgeon, patient, technique, and technology, instead of a rigid and categorical statement, we argued that a balanced response to this challenging question may require compromise. |
