To investigate the clinical effect of left colonic artery (LCA) preservation in laparoscopic radical resection of rectal cancer (LRR) by cephalic median combined approach.

A prospective analysis of 90 patients with LRR using cephalic intermediate combined approach admitted from June 2015 to June 2017 was conducted. According to the different treatment methods of LCA, the patients were divided into two groups by random number table, 45 patients in each group, including unreserved LCA group and reserved LCA group. SPSS 22.0 statistical software was used to analyze the data. Perioperative indicators and other measurement data were represented by (±s) and independent t test. The incidence of complications was determined by χ² test or Fisher’s exact test. Kaplan-Meier parallel log-rank test was used for survival analysis. P<0.05 indicated statistically significant difference.

The operation time and postoperative exhaust time in the retention group were better than those in the non-retention LCA group (P<0.05). There were statistically significant differences in the incidence of postoperative anastomotic leakage (2.2%, 17.8%) and the total incidence of complications (6.7%, 26.7%) between the retention group and the non-retention group (P<0.05). The 3-year overall survival (OS) and disease-free survival (DFS) were 73.3% and 66.7% in the unretained group. The 3-year OS and DFS of the retention group were 77.8% and 68.9%, respectively. There was no significant difference in OS and DFS between the two groups (P=0.464, 0.821).

The retention of LCA in laparoscopic radical resection of rectal cancer through cephalic intermediate combined approach is beneficial to the postoperative recovery of patients, which can improve the anastomotic blood supply and reduce the incidence of complications.