Priority dissecting of the inferior mesenteric artery combined with complete medial approach - novel laparoscopic approach for left-sided colon cancers

Sep 23, 2026

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Purpose: assess the application effect of “priority dissecting of the inferior mesenteric artery combined with complete medial approach (IMA-CMA)” in laparoscopic left-sided colon cancer radical resection. Methods: 99 patients treated between Sep 2021 and May 2023 were analyzed; 68 were included after propensity score matching (PSM) to compare perioperative characteristics. Results: after PSM, IMA-CMA shortened operating time, reduced blood loss, increased harvested lymph nodes and center group nodes, and reduced postoperative stay, without significant differences in positive nodes or complications. Conclusions: IMA-CMA is safe and feasible and supports thorough D3 lymphadenectomy without raising perioperative complications.

LanguageEnglish

CategoryHealthcare

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Pages9

Reading Time23 min

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Abstract

Introduction

Surgical background and rationale

Current surgical approaches

Wang et al. World Journal of Surgical Oncology (2025) 23:46 [https://doi.org/10.1186/s12957-025-03652-1](https://doi.org/10.1186/s12957-025-03652-1) World Journal of Surgical Oncology RESEARCH Open Access Priority dissecting of the inferior mesenteric artery combined with complete medial approach: a novel laparoscopic approach for left-sided colon cancers Yuhan Wang1†, Gang Hu1†, Bin Tang2†, Wenlong Qiu1, Shiwen Mei1, Bo Li1, Zhiwen Yang3* and Jianqiang Tang1* Abstract Purpose To explore the application effect of the technique of “priority dissecting of the inferior mesenteric artery combined with complete medial approach (IMA-CMA)”in laparoscopic left-sided colon cancer radical resection. Methods A total of 99 patients who underwent laparoscopic left-sided colon cancer radical resection with splenicflexure mobilization between September 2021 to May 2023 were included. Sixty-eight of these patients were analyzed after propensity score matching (PSM) . The perioperative characteristics were compared. Results Among these enrolled patients, 45 underwent the traditional approach, and 54 underwent IMA-CMA approach. After PSM, the patients were matched to include 34 patients in each group, with no significant differences in the sex (p = 0 . 618) or location of tumor (p = 0 . 798) between the two groups. The patients in IMA-CMA group had shorter operating time (p = 0 . 032), less intraoperative blood loss (p = 0 . 003), a higher number of harvested lymph nodes (p = 0 . 044) and center group lymph nodes(p = 0 . 037), and a shorter postoperative hospital stay (p = 0 . 011) . Number of positive lymph nodes and postoperative complications were not significantly different between the two groups. Conclusions The technique of IMA-CMA for splenic flexure mobilization is safe and feasible. It can reduce operating time, intraoperative blood loss and postoperative hospital stay, which is conducive to achieving a thorough D3 lymphadenectomy without increasing the incidence of perioperative complications. Keywords Left-sided colon cancer, Laparoscopic colon cancer radical resection, Priority dissecting of the inferior mesenteric artery, Complete medial approach, Splenic flexure mobilization †Yuhan Wang, Gang Hu and Bin Tang contributed equally to this work. *Correspondence: Zhiwen Yang [yangchuanzhe@163.com](yangchuanzhe@163.com)[ ](yangchuanzhe@163.com)Jianqiang Tang [doc_tjq@hotmail.com](doc_tjq@hotmail.com) 1 Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 Panjiayuan South Lane, Chaoyang District, Beijing 100021, China 2 The First Department of General Surgery, Xiangtan Central Hospital of Hunan Province , Xiangtan, Hunan Province, China 3 Department of Colorectal Surgery, The Third People’s Hospital of Datong, Datong City, Shanxi Province, China © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by-nc-n

FAQs

What surgical technique does the study evaluate for left-sided colon cancer?

It evaluates “priority dissecting of the inferior mesenteric artery combined with complete medial approach (IMA-CMA)” during laparoscopic left-sided colon cancer radical resection.

How were patients selected and how were groups compared?

Ninety-nine patients underwent laparoscopic left-sided colon cancer radical resection with splenic flexure mobilization between Sep 2021 and May 2023; 68 were analyzed after propensity score matching (PSM) to compare perioperative outcomes.

Which outcomes improved with the IMA-CMA approach after PSM?

After PSM, the IMA-CMA group had shorter operating time, less intraoperative blood loss, more harvested lymph nodes (including center group nodes), and a shorter postoperative hospital stay.

Does IMA-CMA increase positive lymph nodes or postoperative complications?

No. Number of positive lymph nodes and postoperative complications were not significantly different between the two groups after PSM.

Sep 23, 2026

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