gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2022-21-4-10-20gnck-1771Research ArticleСТАТЬЯ НОМЕРАLEADING ARTICLEВлияет ли высокая перевязка нижней брыжеечной артерии на результаты хирургического лечения больных раком прямой кишки? (метаанализ и системный обзор литературы)Does high ligation of the inferior mesenteric artery affect the results of surgery for rectal cancer? (a systematic review and meta-analysis)ФайзулинР. И.FayzulinR. I.

Файзулин Рашид Ильдарович

ул. Саляма Адиля, д. 2, г. Москва, 123423

Salyama Adilya str., 2, Moscow, 123423

info@gnck.ruТарасовМ. А.TarasovM. A.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Salyama Adilya str., 2, Moscow, 123423

ПономаренкоА. А.PonomarenkoA. A.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Salyama Adilya str., 2, Moscow, 123423

ЧернышовС. В.ChernyshovS. V.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Salyama Adilya str., 2, Moscow, 123423

РыбаковЕ. Г.RybakovE. G.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Salyama Adilya str., 2, Moscow, 123423

ФГБУ «НМИЦ колопроктологии им. А.Н. Рыжих» Минздрава РоссииРоссияRyzhikh National Medical Research Center of ColoproctologyRussian Federation2022231120222141020Copyright © Файзулин Р.И., Тарасов М.А., Пономаренко А.А., Чернышов С.В., Рыбаков Е.Г., 20222022Файзулин Р.И., Тарасов М.А., Пономаренко А.А., Чернышов С.В., Рыбаков Е.Г.Fayzulin R.I., Tarasov M.A., Ponomarenko A.A., Chernyshov S.V., Rybakov E.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1771ЦЕЛЬ

ЦЕЛЬ: сравнить методы высокой и низкой перевязки нижней брыжеечной артерии (НБА) в отношении непосредственных и отдаленных результатов лечения больных раком прямой и сигмовидной кишки.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ: метаанализ выполнен в соответствии с практикой и рекомендациями PRISMA.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ: в метаанализ включено 18 исследований, среди которых 5 рандомизированных и 13 ретро- спективных. Результаты метаанализа показали, что при сохранении ЛОА (левой ободочной артерии) несостоятельность анастомоза статистически значимо ниже, чем при высокой перевязке НБА (ОШ = 1,60; ДИ 1,23–2,10; р = 0,0006). Различий в продолжительности оперативного вмешательства, объеме крово- потери, частоте мобилизации левого изгиба, количестве обнаруженных лимфатических узлов, частоте нарушений функции мочеиспускания, количестве послеоперационных койко-дней и 5-летней безрецидивной выживаемости не получено.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ: низкая перевязка НБА способствует улучшению кровоснабжения анастомоза и уменьшает риск его несостоятельности.

AIM

AIM: to compare methods of high and low ligation of the inferior mesenteric artery (IMA) in relation to early and late outcomes in surgery for rectal and sigmoid cancer.

MATERIALS AND METHODS

MATERIALS AND METHODS: the systematic review performed in accordance with PRISMA practice and guidelines.

RESULTS

RESULTS: eighteen studies (5 randomized clinical trials and 13 retrospective studies) are included in the study. The meta-analysis demonstrated that left colic artery (LCA) preservation significantly reduced the incidence of anasto- motic leaks compared with high ligation of IMA (OR = 1.60; CI 1.23–2.10; p = 0.0006). There were no differences in operation time, blood loss, frequency of splenic flexure mobilization, number of harvested lymph nodes, incidence of urinary dysfunction, postoperative hospital stay and 5-year disease-free survival.

CONCLUSION

CONCLUSION: low ligation of the IMA improves the blood supply to the anastomosis and reduces the risk of anasto- motic leakage.

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The authors declare that there are no conflicts of interest present.