To investigate the clinical effect of anastomotic blood flow estimation assisted by ICG imaging in laparoscopic total mesangial resection（TME）for rectal cancer with left colic artery preservation.

The clinical data of 120 patients who underwent laparoscopic radical resection with left colic artery preservation from January 2018 to December 2020 were selected. According to the random number table method，they were divided into ICG group and control group，60 cases in each group. The ICG group underwent laparoscopic TME with left colonic artery preservation assisted by ICG imaging technology，while the control group underwent laparoscopic TME with left colonic artery preservation. Data were analyzed by SPSS 20.0 statistical software. Perioperative indicators and other measurement data were represented by（

The first anal exhaust time and hospital stay in ICG group were shorter than those in the control group，and the differences were statistically significant（P<0.05）. There were no significant differences in operation time，intraoperative blood loss，length of resected bowel and number of lymph nodes scanned between the two groups（P>0.05）. The total incidence of postoperative complications in ICG group（6.7%）was lower than that in control group（20.0%），and the difference was statistically significant（P<0.05）. All patients were followed up for a median of 19 months（7~43 months）. There was no tumor metastasis or recurrence in ICG group，while there was 1 case of liver metastasis and 1 case of pelvic recurrence in control group. There was no significant difference in local recurrence and distant metastasis between the two groups（P>0.05）.

ICG imaging assisted anastomotic blood supply judgment has a significant effect in laparoscopic TME with left colic artery preservation. It can guide accurate bowel resection by evaluating the target intestinal blood perfusion during the operation，reduce the incidence of anastomotic leakage caused by insufficient anastomotic blood supply，and has a good short-term prognosis.