To investigate the clinical effect of laparoscopic rectal cancer D3 radical surgery with left colon artery for patients with advanced colorectal cancer.

From December 2015 to January 2018, clinical data of 60 patients with advanced colorectal cancer were analyzed retrospectively, who were divided into the reserved group and the unreserved group according to the different surgical procedures. Patients in the reserved group (n=32) underwent laparoscopic rectal cancer D3 radical operation with preservation of left colon artery, while high-ligation of IMA was performed in the unreserved group (n=28). SPSS 22.0 software were used for statistical analysis. Measurement data such as the perioperative index, number of harvested lymph nodes were expressed as (±s) and were analyzed by using independent sample t test. Count data such as complication rate were expressed as percentage and were analyzed by using χ² test or Fisher’s test. A P value of <0.05 was considered as statistically significant difference.

The anal exhaust time and marginal arch pressure in the reserved group were significantly less than those in the unreserved group respectively (P<0.05), while in terms of the other perioperative indicators there were no significant difference (P>0.05). There was no statistically significant difference between two groups in terms of number of harvested lymph nodes and positive lymph nodes (P>0.05), however the number of 253 lymph nodes in the reserved group was significantly more than that in the unreserved group (P<0.05). The incidence of anastomotic leakage of 3.1% (1/32) in the reserved group was significantly less than 10.7% (3/28) in the unreserved group (P<0.05). There was no statistically significant difference between the two groups in terms of incidence of recurrence and metastasis at 1 year after operation (P<0.05).

Compared with high-ligation of IMA in laparoscopic D3 radical surgery, preserving the left colon artery does not increase postoperative tumor recurrence and metastasis, and could effectively reduce the incidence of anastomotic leakage. It has good prospects.