Study of the Preservation of the Left Colic Artery on Rectum Cancer Surgery

Study Overview
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Brief Summary
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To evaluate the influence to the blood supply of the anastomosis and the harvest of the No. 253 lymph nodes in different surgical methods--- preserving the left colic artery (LCA) and resect the No. 253 lymph node specifically in the radical resection of rectal carcinoma or dividing at the root of the inferior mesenteric artery (IMA) in the radical resection of rectal carcinoma.

Detailed Description
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Methods: The patients who got rectal carcinoma are divided into two groups. Both groups will receive the radical resection of rectal carcinoma. We preserve the left colic artery and resect the No. 253 lymph node specifically in Group A and divide at the root of the inferior mesenteric artery in Group B, We insert a trocar into the arterial arcade at the proximal site of the anastomosis and measure the blood pressure of the arterial arcade in the operation, which can reflect the blood supply of the anastomosis. Besides, We will measure the length of the colon from the anastomosis to the level of the root of the IMA. Expecting Results：The blood pressure of the arterial arcade in Group A will be higher than that in Group B. And the patients in Group A will have less chance to get anastomotic fistula. Expecting Conclusions: Preserving the LCA and resecting the No. 253 lymph node specifically in the radical resection of rectal carcinoma can improve the blood supply of the anastomosis and decrease the incidence of anastomotic fistula, and won't affect the harvest of the No. 253 lymph node.

Official Title
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Affection on Anastomotic Blood Flow and the Lymph Nodes Dissection Between Division at the Root of the Inferior Mesenteric Artery and Preserving the Left Colic Artery in Rectum Cancer Surgery

Conditions
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Rectum Cancer

Intervention / Treatment
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* Procedure: preserving the left colic artery
* Procedure: not preserving the left colic artery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients coming to FirstJilinU diagnosed rectum cancer by endoscopy and pathology. The rectum cancer is the first malignant neoplasm the patient has got. The cancer is solitary, and is 3cm to 20cm to the anus. The surgical method is limited to Dixon. Exclusion Criteria: Being in the acute phase of inflammation before operation and emergency surgery. Patients receiving steroid medication or preoperative radiotherapy。 Discovering macrometastasis before or in the operation. The rectum cancer that can't be radical resected.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: preserving the left colic artery<br>We preserve the left colic artery and resect the No. 253 lymph node during the rectal surgery. | Procedure: preserving the left colic artery<br>* The root of the inferior mesenteric artery(IMA) was carefully dissected and the artery wall was exposed all the way to the bifurcation of the left colic artery(LCA) and the superior rectal artery (SRA), exposing the LCA from its root until the inferior mesenteric vein (IMV) was recognized. Subsequently, dissection was continued along the IMV up to the level of the root of the IMA. Then the sigmoid mesentery was transected from the root of the IMA to the IMV, and the IMV and the root of the SRA were ligated. Finally, the adipose tissue with the lymph nodes in the area surrounded by the IMA, IMV, and LCA was dissected, with preservation of the LCA .<br>|
| Experimental: not preserving the left colic artery<br>We preserve the high ligation of the inferior mesenteric artery during the rectal surgery. | Procedure: not preserving the left colic artery<br>* The root of the IMA was exposed and the fatty tissue around the root of the IMA was swept in order to maximize the lymph node retrieval rate. Subsequently, the IMA was ligated 1 cm from the aorta to avoid damaging the nerves.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Blood Pressure of the Arterial Arcade |  | after ligating the inferior mesentric artery or superior rectal artery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Distal Colon Length |  | after digestive tract reconstruction |