Radical surgery for rectal cancer does not require preservation of the left colonic artery, which completely ensures the anastomotic blood flow to the colonic-anal canal.
The arteries of colonic blood anastomose with each other at the inner edge of the colon to form an arterial arch, which is the colonic marginal artery. The marginal artery branches out again, and from these branches, long and short branches can enter the intestinal wall in a perpendicular direction to the intestinal canal. The long branch starts from the long branch and supplies blood to two-thirds of the intestinal wall on the side of the mesenteric margin; the long branch starts in the subplasma membrane between the colonic bands and then penetrates into the muscular layer, along the way it sends out most of the fine branches that also supply blood to two-thirds of the intestinal wall on the side of the mesenteric margin, and there are small branches to the intestinal lipid pendant; its terminal branches cross the omental band and the intestinal wall near the independent band, and finally distribute to one-third of the intestinal wall on the opposite side of the mesentery. Therefore, the long branch is the main nutritive artery of the intestinal wall, and the long branch should not be stretched too much during surgery to avoid injury to the long branch. Ren Hui, Department of Colorectal and Anorectal Surgery, Second Hospital of Jilin University
Therefore, as long as the arterial arch at the edge of the anastomosis is guaranteed to be intact, the anastomotic blood flow can be completely ensured.
Moreover, by not preserving the left colonic artery, the length of the left hemicocele can be extended even more, thus reducing the anastomotic tension of the anastomosis.
Especially in laparoscopic radical colorectal cancer surgery, there is no need to preserve the left colonic artery.