The Feasibility of Laparoscopic TSME Preserving Left Colic Artery and Superior Rectal Artery for Upper Rectal Cancer

Background Laparoscopic TSME preserving left colic artery and superior rectal artery is still a technical challenging procedure. To show the feasibility of this procedure for upper rectal cancer, we conducted this study. Methods A total of 184 patients with upper rectal cancer were retrospectively collected in our cancer center between Apr 2010 and Apr 2017. These patients were treated by either laparoscopic TSME (n=46) or laparoscopic TME (n=138). In the group of TSME, left colonic artery and superior rectal artery were preserved while they were not in TME group. Results The operation time in TSME group was longer than that in TME group (218.56 ± 35.85 vs. 201.13 ± 42.65, P=0.004). Further, the resected lymph nodes in TSME group is more than that in TME group (19.43 ± 9.46 vs. 18.03 ± 7.43, P= 0.024). The blood loss between TSME and TME groups achieved no significance. There was no mortality occured in either TSME or TME group. One patient in TME group was converted to laparotomy. Total postoperative complication rate in TSME and TME groups were 8.7% and 17.4%, respectively. For severe complication between the two groups (anastomotic leakage and stenosis), they showed no difference. Conclusions Laparoscopic TSME preserving left colic artery and superior rectal artery can be safely conducted for upper rectal cancer.