吻合口漏是腹腔镜直肠癌围手术期的主要并发症之一。为降低其发生率，外科医师在手术过程中选择保留左结肠动脉来增加吻合口血供。但由于肠系膜下动脉（IMA）的分支变异较大，术前对IMA分型以及周围结构判断不足，在手术过程中处理IMA根部时导致各种意外出血，而被迫选择结扎IMA根部。利用CT血管重建技术对IMA进行影像学分型，一方面有利于精准保留左结肠动脉，减少不必要的手术时间；另一方面有助于判断左结肠动脉和肠系膜下静脉之间的关系，达到规范化清扫D3站淋巴结的目的。因此，笔者认为，应将"通过CT血管重建技术对IMA进行精准化分型"纳入诊疗规范中，使直肠癌的外科治疗更加个体化，精准化；但这尚需要多中心大样本的前瞻性研究来提供循证医学证据。

Anastomotic leakage is one of the severe complications of laparoscopic assisted-resection of rectal cancer. In order to increase the blood pressure of anastomosis, many surgeons choose to be preserved the left colon artery during operation. However, due to the large branch variation of the inferior mesenteric artery (IMA), the artery bleeding was frequently by various accidents during the operation. The vascular reconstruction for the classification of the IMA could accurately preserve the left colon artery (LCA), and completely dissected D3 lymph nodes. Therefore, we think that the "accurate classification of the inferior mesenteric artery by abdominal CT vascular reconstruction" should be routine examination before rectal cancer surgery. However, in the further, this requires a multi-center large sample clinical studies to provide medical evidence.