{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:12:46Z","timestamp":1783905166141,"version":"3.55.0"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The optimal level of inferior mesenteric artery (IMA) ligation during colorectal cancer (CRC) surgery remains controversial. Low ligation with preservation of the left colic artery (LCA) may maintain bowel perfusion, but concerns persist regarding adequacy of central lymph node dissection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To evaluate the technical feasibility and short-term safety of central lymphadenectomy at the IMA root during low ligation with preservation of the LCA in laparoscopic CRC surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective observational study included 30 patients with nonmetastatic sigmoid colon or rectal adenocarcinoma who underwent laparoscopic resection between October 2025 and April 2026 at the National Cancer Institute, Cairo University. Low ligation of the IMA with LCA preservation and central lymphadenectomy at the IMA root was performed in all cases. Feasibility, lymph node retrieval, operative outcomes, and short-term postoperative outcomes were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All procedures were completed laparoscopically without conversion to open surgery. Preservation of the LCA and successful central lymphadenectomy were achieved in all patients. Mean total lymph node harvest was 24 \u00b1 4, while mean central node retrieval was 5 \u00b1 1. R0 resection was achieved in all cases. Mean operative time was 180 \u00b1 19 minutes. Postoperative complications occurred in 10% of patients, including one case of anastomotic leakage (3.3%). Median hospital stay was 4 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Central lymphadenectomy during low ligation of the IMA is feasible and safe in laparoscopic CRC surgery, providing adequate nodal harvest while preserving colonic vascular supply.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261468936","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:40:27Z","timestamp":1783575627000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of Central Lymphadenectomy During Low Ligation of Inferior Mesenteric Artery in Laparoscopic Colorectal Cancer Surgery"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5823-0634","authenticated-orcid":false,"given":"Aly El Faqeh Mohamed","family":"Okasha","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fouad Abdelshahid","family":"Fouad","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Islam Ali","family":"Soliman","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid Akmal","family":"Shafie","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032651"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(05)70221-7"},{"issue":"4","key":"e_1_3_4_5_1","first-page":"626","article-title":"Level of arterial ligation in rectal cancer surgery: Low tie versus high tie","volume":"248","author":"Lange MM","year":"2008","unstructured":"4.Lange MM, , Buunen M, , van de Velde CJH, et al. Level of arterial ligation in rectal cancer surgery: Low tie versus high tie. Ann Surg 2008;248(4):626\u2013632.","journal-title":"Ann Surg"},{"key":"e_1_3_4_6_1","first-page":"605","article-title":"Clinical significance of left colic artery preservation in colorectal cancer surgery","volume":"30","author":"Matsuda K","year":"2015","unstructured":"5.Matsuda K, , Hotta T, , Takifuji K, et al. Clinical significance of left colic artery preservation in colorectal cancer surgery. Int J Colorectal Dis 2015;30:605\u2013611.","journal-title":"Int J Colorectal Dis"},{"issue":"3","key":"e_1_3_4_7_1","first-page":"674","article-title":"Significance of apical lymph node metastasis in colorectal cancer","volume":"17","author":"Huh JW","year":"2010","unstructured":"6.Huh JW, , Kim HR. Significance of apical lymph node metastasis in colorectal cancer. Ann Surg Oncol 2010;17(3):674\u2013680.","journal-title":"Ann Surg Oncol"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.23922\/jarc.2019-018"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.24.1448"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.774782"},{"key":"e_1_3_4_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58091143"},{"key":"e_1_3_4_12_1","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2021-0149"},{"key":"e_1_3_4_13_1","first-page":"34","article-title":"Potential short-term outcome advantage of low versus high ligation of inferior mesenteric artery for sigmoid and rectal cancer: Propensity score matching analysis","volume":"23","author":"Wang C","year":"2023","unstructured":"12.Wang C, , Guo J, , Guo T, et al. Potential short-term outcome advantage of low versus high ligation of inferior mesenteric artery for sigmoid and rectal cancer: Propensity score matching analysis. BMC Surg 2023;23:34.","journal-title":"BMC Surg"},{"key":"e_1_3_4_14_1","first-page":"549","article-title":"Ideal level of ligation of the inferior mesenteric artery: An old debate for a current surgical approach","volume":"92","author":"Suffat LP","year":"2021","unstructured":"13.Suffat LP, , Petrelli LC, , Mondini G, et al. Ideal level of ligation of the inferior mesenteric artery: An old debate for a current surgical approach. Ann Ital Chir 2021;92:549\u2013553.","journal-title":"Ann Ital Chir"},{"issue":"2","key":"e_1_3_4_15_1","first-page":"643","article-title":"Indocyanine green fluorescence angiography versus standard intraoperative methods for prevention of anastomotic leak in colorectal surgery: A systematic review and meta-analysis","volume":"34","author":"Arezzo A","year":"2020","unstructured":"14.Arezzo A, , Bonino MA, , Ris F, et al. Indocyanine green fluorescence angiography versus standard intraoperative methods for prevention of anastomotic leak in colorectal surgery: A systematic review and meta-analysis. Surg Endosc 2020;34(2):643\u2013650.","journal-title":"Surg Endosc"}],"container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10926429261468936","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10926429261468936","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10926429261468936","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:43:50Z","timestamp":1783903430000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10926429261468936"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":14,"alternative-id":["10.1177\/10926429261468936"],"URL":"https:\/\/doi.org\/10.1177\/10926429261468936","relation":{},"ISSN":["1092-6429","1557-9034"],"issn-type":[{"value":"1092-6429","type":"print"},{"value":"1557-9034","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]},"article-number":"10926429261468936"}}