To analyze the clinical value of submesenteric artery (IMA) classification in laparoscopic low anterior rectal resection.

A total of 107 patients who underwent laparoscopic low anterior rectal resection from May 2019 to May 2022 were retrospectively selected. IMA was divided into type Ⅰ group (n=43), type Ⅱ group (n=24), type Ⅲ group (n=28) and type Ⅳ group (n=12) according to the results of preoperative three-dimensional vascular reconstruction by Murono classification method. SPSS 22.0 was used to analyze the data. Count data such as complications were represented by [cases (%)], χ² test or Fisher exact probability method were used for multi-group comparison, and non-parametric rank sum test was used for rank count data. Measurement data such as perioperative indexes were expressed with (), and t test was used for comparison among multiple groups. P<0.05 was considered statistically significant.

There was no significant difference in LIMA and DIMA among IMA subtypes (P>0.05). In 107 patients, low IMA ligation was performed in type Ⅰ, type Ⅱ and type Ⅲ, and high IMA ligation was performed in type Ⅳ. The first postoperative exhaust time of group Ⅳ was significantly longer than that of group Ⅰ, type Ⅱ and type Ⅲ (P<0.05). The incidence of anastomotic leakage, defecation difficulty and the total incidence of complications in group Ⅳ were significantly higher than those in group Ⅰ to Ⅲ (P<0.05).

Preoperative three-dimensional vascular reconstruction was performed to understand IMA classification and determine the distance between IMA and left colic artery (LCA) and abdominal aorta, so as to select the most appropriate IMA ligation method, reduce the risk of collateral damage caused by blind surgery, and achieve the purpose of accurately preserving LCA, which has a positive effect on promoting the recovery of intestinal function in patients and reducing the incidence of anastomotic leakage.