Safety, Survival, and Efficacy of Preserving Left Colonic Artery in Rectal Cancer Surgery: A Meta-Analysis and Review.

Purpose: This study analyzes the effect, long-term survival rate, and complications about preserving the left colonic artery (LCAP) in rectal cancer surgery. Methods: Relevant articles were systematically retrieved from multiple electronic databases, for example, EMBASE, BioMed Central, PubMed, Web of Science, and Cochrane. The time for retrieving was from the establishment of the database to December 31, 2018. Evaluated endpoints were effect of LCAP on the curative effect of rectal neoplasms, such as operation time, the amount of bleeding during the operation, root lymph nodes positive number, and the related complications (anastomotic leakage, etc.), postoperative urinary retention, 5-year survival rate, and recurrence differences in rates. Results: Totally 12 studies were included in this review. The meta-analysis showed that LCAP has less operation time and lower anastomotic leakage incidence. Intraoperative bleeding, root lymph nodes, and other complications did not show any significant difference. Conclusions: LCAP in radical rectal cancer surgery ensures both the radical resection of the tumor and the safety of the operation. So it can provide a new approach to the management of blood vessels and lymph nodes.