Preserving inferior mesenteric artery during elective laparoscopic sigmoidectomy for diverticulitis.

Document Type : Review Article


1 Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy

2 Department of General Surgery, Carlo Urbani Hospital, Jesi (Ancona), Italy


Context: During a Laparoscopic Sigmoid Resection (LSR) for patients with diverticulitis, the inferior mesenteric
artery may or may not be preserved depending on the surgical technique. We aimed to evaluate results after
LSR with Inferior Mesenteric Artery Preservation (IMAP) and Superior Rectal Artery Preservation (SRAP)
in terms of anastomotic leakages and denervation of the hypogastric nerves with consequent genitourinary and
defecation alterations.
Evidence Acquisition: A retrospective PubMed research of manuscripts published from January 2000 to January
2020 was conducted, enrolling studies about patients with symptomatic diverticular disease who underwent surgery.
Results: A total of 1685 patients with IMAP and SRAP were included in the study.
Conclusion: This retrospective review showed that patients with IMAP-SRAP demonstrated an equal or lower
leakage rate with reduced incidence of stoma, lower incidence of defecation disorders, and similar or improved
quality of life compared with laparoscopic left colectomy with no IMAP.


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