{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:31:24Z","timestamp":1789655484058,"version":"4.0.1"},"reference-count":56,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,1,28]],"date-time":"2019-01-28T00:00:00Z","timestamp":1548633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>In colorectal cancer, ligation of the inferior mesenteric artery (<jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content>) is a standard surgical approach. In contrast, ligation of the <jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content> is not mandatory during treatment of diverticular disease. The object of this meta\u2010analysis was to assess if preservation of the <jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content> reduces the risk of anastomotic leakage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A search was performed up to August 2018 using the following electronic databases: <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\/PubMed, <jats:styled-content style=\"fixed-case\">ISI<\/jats:styled-content> Web of Knowledge and Scopus. The measures of treatment effect utilized risk ratios for dichotomous variables with calculation of the 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>. Data analysis was performed using the meta\u2010analysis software Review Manager 5.3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight studies met the inclusion criteria and were included in the meta\u2010analysis: two randomized controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) and six non\u2010<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s with 2190 patients (<jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content> preservation 1353, ligation 837). The rate of anastomotic leakage was higher in the <jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content> ligation group (6%) than the <jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content> preservation group (2.4%), but this difference was not statistically significant [risk ratio (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) 0.59, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.26\u20131.33, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a055%]. The conversion to laparotomy was significantly lower in the <jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content> ligation group (5.1%) than in the <jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content> preservation group (9%) (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.74, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.14\u20132.65, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%). Regarding the other outcomes (anastomotic bleeding, bowel injury and splenic damage), no significant differences between the two techniques were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta\u2010analysis failed to demonstrate a statistically significant difference in the anastomotic leakage rate when comparing <jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content> preservation with <jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content> ligation. Thus, to date there is insufficient evidence to recommend the <jats:styled-content style=\"fixed-case\">IMA<\/jats:styled-content>\u2010preserving technique as mandatory in resection for left\u2010sided colonic diverticular disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14547","type":"journal-article","created":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T18:51:29Z","timestamp":1546627889000},"page":"623-631","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Sigmoid resection for diverticular disease \u2013 to ligate or to preserve the inferior mesenteric artery? Results of a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"21","author":[{"given":"R.","family":"Cirocchi","sequence":"first","affiliation":[{"name":"Department of Surgical Science University of Perugia Piazza dell'Universit\u00e0 1 Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9618-3187","authenticated-orcid":false,"given":"G.","family":"Popivanov","sequence":"additional","affiliation":[{"name":"Department of Surgery Military Medical Academy Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. A.","family":"Binda","sequence":"additional","affiliation":[{"name":"Department of Surgery Galliera Hospital Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8047-338X","authenticated-orcid":false,"given":"B. M.","family":"Henry","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. A.","family":"Tomaszewski","sequence":"additional","affiliation":[{"name":"International Evidence\u2010Based Anatomy Working Group Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. J.","family":"Davies","sequence":"additional","affiliation":[{"name":"Cambridge Colorectal Unit Addenbrooke's Hospital Cambridge University Hospitals NHS Trust Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Di Saverio","sequence":"additional","affiliation":[{"name":"Cambridge Colorectal Unit Addenbrooke's Hospital Cambridge University Hospitals NHS Trust Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,28]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Atlas of Surgical Techniques for the Colon, Rectum, and Anus","author":"Mutch MG","year":"2013"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2017.03.012"},{"key":"e_1_2_8_4_1","volume-title":"Current Therapy in Colon and Rectal Surgery","author":"Boutros M","year":"2017"},{"key":"e_1_2_8_5_1","first-page":"1150","volume-title":"Gray's Anatomy. 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