To investigate the effect of preserving the left colonic artery (LCA) on the clinical efficacy of laparoscopic anterior resection of rectal cancer.

The clinical data of 186 patients who underwent laparoscopic anterior resection of rectal cancer in Shanxi Cancer Hospital from July 2015 to July 2018 were retrospectively analyzed, including 80 cases in the LCA preserving group (treatment group) and 106 cases in the non LCA preserving group (control group). The operation related indexes were compared between the two groups, including operation time, blood loss, changes of proximal intestinal ischemia, total number of lymph node dissection, and total number of the 253 group lymph node dissection, the rate of prophylactic stoma, separated spleen flexure, the positive rate of the 253 group lymph node metastasis, hospitalization duration, postoperative complications (anastomotic leakage, anastomotic bleeding, abdominal infection, etc.) and postoperative follow-up results.

There was no significant difference between the two groups in terms of operation time, blood loss, total number of lymph node dissection, and total number of the 253 group lymph node dissection, the positive rate of the 253 group lymph node metastasis, exhaust time, hospitalization duration , anastomotic bleeding, abdominal infection, the stenosis of anastomosis and the retention of urine (P＞0.05). The incidence of anastomotic leakage, The rate of prophylactic stoma (P=0.038), separated spleen flexure (P=0.038) were significantly lower in the treatment group than in the control group, the exhaust time were also lower in the treatment group (t=6.935, P＜0.05), the incidence of anastomotic leakage were also lower in the treatment group (χ²=3.908, P=0.048). All patients were followed up for 6~48 months. The local recurrence rate and distant metastasis rate in the treatment group were 2.5% and 11.3%, while those in the control group were 2.8% and 12.3%, with no statistical significance (P＞0.05). There was no significant difference in cumulative survival rates between the two groups (P＞0.05).

Preservation of LCA in laparoscopic anterior resection of rectal cancer in D3 lymph node dissection and long-term curative effect, can achieve the same clinical effect as non preservation of LCA, and can significantly protect the anastomotic blood supply, reduce anastomotic leakage, and promote the early recovery of intestinal function after operation. This operation is safe and feasible.