{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T05:48:08Z","timestamp":1764049688267,"version":"3.45.0"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"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":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Studies have suggested little oncological benefit to \u2018high\u2010tie\u2019 resection of the inferior mesenteric artery pedicle in rectal cancer surgery but have all been based on subjective surgical intent rather than objective, quantifiable measurements. In this study, we aimed to assess the level of transection objectively and investigate its influence on long\u2010term oncological outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>All patients undergoing elective resection for rectal cancer with curative intent between 2012 and 2020 in a tertiary referral centre were included. IMA stump length was measured on postoperative CT scan and patients categorised as having undergone \u2018high tie\u2019 (left colic artery absent and stump &lt;40\u2009mm) resection or \u2018low\u2010tie\u2019 (left colic artery preserved or IMA stump &gt;40\u2009mm) resection. Propensity score matching was undertaken to produce comparable groups and multivariable regression modelling was performed pre\u2010 and post\u2010matching. Principal outcome parameters were overall survival and local recurrence\u2010free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      466 patients (mean 65.3\u2009years, 33% female) were available for analysis. Mean (SD) IMA stump length was 18 (10) mm in the high\u2010tie group and 47 (18) mm in the low\u2010tie group respectively. After propensity score matching, two groups of 152 patients were compared. Multivariable survival analysis showed a significantly better overall (HR 1.84 [1.16\u20132.93],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010) and local recurrence\u2010free (HR 2.23 [1.00\u20134.97],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049) survival for patients in the high\u2010tie group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In contrast to other studies, our study has used objective measurements to show an association between central IMA transection and improved oncological outcomes. This association is preserved on multivariable analysis of the propensity score matched cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70244","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T13:23:50Z","timestamp":1761657830000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Shorter residual inferior mesenteric artery stump length on objective CT measurement is associated with improved oncological outcomes in rectal cancer surgery: A propensity score matched analysis"],"prefix":"10.1111","volume":"27","author":[{"given":"A.","family":"Kohler","sequence":"first","affiliation":[{"name":"John Goligher Colorectal Unit St James's University Hospital  Leeds UK"},{"name":"Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Khalil","sequence":"additional","affiliation":[{"name":"John Goligher Colorectal Unit St James's University Hospital  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. J. A.","family":"Wilcox","sequence":"additional","affiliation":[{"name":"Department of Radiology St. James's University Hospital, Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. L.","family":"Byers","sequence":"additional","affiliation":[{"name":"John Goligher Colorectal Unit St James's University Hospital  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. R.","family":"Bundred","sequence":"additional","affiliation":[{"name":"John Goligher Colorectal Unit St James's University Hospital  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. J. M.","family":"Tolan","sequence":"additional","affiliation":[{"name":"Department of Radiology St. James's University Hospital, Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. P.","family":"Tiernan","sequence":"additional","affiliation":[{"name":"John Goligher Colorectal Unit St James's University Hospital  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"149","article-title":"The lymphatics of the colon","volume":"2","author":"Jamieson JK","year":"1909","journal-title":"Proc R Soc Med"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2008.01735.x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60485-2"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010580"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.133.8.894"},{"issue":"44","key":"e_1_2_13_7_1","first-page":"3582","article-title":"Clinical effect of preservation of the left colonic artery in laparoscopic anterior resection for rectal cancer","volume":"96","author":"Niu JW","year":"2016","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.13032"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002947"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs5.71"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2017.12.030"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-018-1458-7"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2021-0149"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-019-03291-5"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-021-02222-5"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-019-02021-x"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0284185115583033"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2017.03.012"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-019-02094-0"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000369938"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-016-0819-3"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-07203-0"},{"key":"e_1_2_13_24_1","doi-asserted-by":"crossref","first-page":"S76","DOI":"10.1002\/jso.26362","article-title":"High versus low ligation of the inferior mesenteric artery during laparoscopic rectal cancer surgery: a prospective study of surgical and oncological outcomes","volume":"123","author":"Feng W","year":"2021","journal-title":"J Surg Oncol"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.70244","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T04:55:19Z","timestamp":1764046519000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.70244"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,28]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/codi.70244"],"URL":"https:\/\/doi.org\/10.1111\/codi.70244","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"type":"print","value":"1462-8910"},{"type":"electronic","value":"1463-1318"}],"subject":[],"published":{"date-parts":[[2025,10,28]]},"assertion":[{"value":"2025-03-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70244"}}