To study the value of computed tomography angiography (CTA) in evaluating the classification of the inferior mesenteric artery (IMA) and guiding laparoscopic rectal cancer surgery.

The clinical data of 195 patients with rectal cancer who underwent laparoscopic radical resection of rectal cancer from December 2021 to January 2024 were analyzed retrospectively. The patients were divided into two groups according to the examination method: Observation Group: 107 patients who underwent CTA examination; Control Group: 88 patients who underwent conventional CT examination. Data were analyzed using SPSS 22.0 software. Data were expressed as (±s), [M(IQR)] (median and interquartile range), or [cases (%)] (number of cases and percentage). Statistical tests including t test, nonparametric Rank-Sum test, χ² test, or Fisher’s exact test were used as appropriate. P<0.05 was considered statistically significant.

The operation time, intraoperative blood loss, length of hospital stay, and time to first ambulation after surgery in the Observation Group were significantly better than those in the Control Group, with Cohen’s |d|>0.8 for all indicators, and the differences were statistically significant (all P<0.05). The total incidence of postoperative complications in the Observation Group was lower than that in the Control Group, with a statistically significant difference (P<0.05). The coincidence rate between the intraoperative findings of mesenteric blood vessels and their branches and the preoperative multi-slice spiral computed tomography angiography (MSCTA) results in the Observation Group was significantly higher than that in the Control Group (100% vs. 90.9%, P<0.05). Among patients with IMA classification of Type Ⅰ–Ⅲ, the operation time and intraoperative blood loss in the Observation Group were lower than those in the Control Group, and the differences were statistically significant (all P<0.05).

Performing CTA before radical resection of rectal cancer can assist surgeons in efficiently planning the operation and significantly shortening the operation time; it helps clarify the vascular distribution preoperatively and enables precise intraoperative operation to reduce blood loss; it optimizes the surgical plan, reduces the incidence of postoperative complications, and strongly promotes the postoperative recovery of patients.