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This is a prospective randomized study aimed to verifying the short and long-term results of inferior mesenteric artery preservation following colorectal resection for diverticular disease
This study wants to demonstrate that the preservation of the inferior mesenteric artery allow to improve postoperative defecatory function and improve patient's quality of life.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Inferior mesenteric artery preservation | Experimental | Performing colorectal resection for diverticular disease the IMA was preserved ligating the sigmoids arteries close to colonic wall. |
|
| Inferior mesenteric ligation | Active Comparator | Performing colorectal resection the IMA was sectioned just below the origin of left colic artery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| IMA preserving | Procedure | Performing left hemicolectomy, sigmoidectomy or rectal resection the IMA was preserved ligating the sigmoids arteries close to the colonic wall |
|
| Measure | Description | Time Frame |
|---|---|---|
| Defecatory disorders | the presence of defecatory disorders was evaluated (Costipation, Evacuation frequency,evacuation urgency, fragmented evacuation,flatus incontinence, liquid incontinence) | 6 months from surgery |
| Defecatory disorders | the presence of defecatory disorders was evaluated (Costipation, Evacuation frequency,evacuation urgency, fragmented evacuation,flatus incontinence, liquid incontinence) | 12 months from surgery |
| Defecatory disorders | the presence of defecatory disorders was evaluated (Costipation, Evacuation frequency,evacuation urgency, fragmented evacuation,flatus incontinence, liquid incontinence) | 6 years from surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Constipation | The incidence and severity of postoperative constipation was evaluated with Cleveland Clinic Constipation Score ( score range from 0 to 30, the higher score defines worse constipation status) | 6 months from surgery |
| Constipation |
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Inclusion Criteria:
Exclusion Criteria:
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39814952 | Derived | Mari FS, Chiarini L, Trampetti L, Savina C, Cosmi F, Cicolani A, Gasparrini M, Brescia A. Preservation of inferior mesenteric artery reduces short- and long-term defecatory dysfunction after laparoscopic colorectal resection for diverticular disease: An RCT. Surg Endosc. 2025 Mar;39(3):1761-1769. doi: 10.1007/s00464-024-11490-7. Epub 2025 Jan 15. |
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| IMA sectioning | Procedure | Performing left emicolectomy, sigmoidectomy or rectal resection the IMA is sectioned after the origin of left colic artery. |
|
The incidence and severity of postoperative constipation was evaluated with Cleveland Clinic Constipation Score ( score range from 0 to 30, the higher score defines worse constipation status)
| 12 months from surgery |
| Constipation | The incidence and severity of postoperative constipation was evaluated with Cleveland Clinic Constipation Score ( score range from 0 to 30, the higher score defines worse constipation status) | 6 years from surgery |
| Incontinence | The presence of fecal incontinence was evaluated with Cleveland Clinic Incontinence Score( score range from 0 to 20, the higher score defines worse symptoms) | 6 months from surgery |
| Incontinence | The presence of fecal incontinence was evaluated with Cleveland Clinic Incontinence Score( score range from 0 to 20, the higher score defines worse symptoms) | 12 months from surgery |
| Incontinence | The presence of fecal incontinence was evaluated with Cleveland Clinic Incontinence Score( score ranges from 0 to 20, the higher score defines worse symptoms) | 6 years from surgery |
| Anorectal Muscles function | The anorectal muscles function was evaluated with anorectal manometry( sphincter lenght, maximum squeeze pression, resting anal pressure, squeeze duration, maximum pressure sustained) | 6 months from surgery |
| Anorectal Muscles function | the anorectal muscles function was evaluated with anorectal manometry ( sphincter lenght, maximum squeeze pression, resting anal pressure, squeeze duration, maximum pressure sustained) | 6 years from surgery |
| Postoperative quality of life | the postoperative QOL(quality of life) was evaluated with EORTC-30 tests( European organization for research and treatment of cancer, scores range from 0 to 100; a higher score represents a higher ("better") level of functioning, or a higher ("worse") level of symptoms) | 6 months from surgery |
| Postoperative quality of life | the postoperative QOL was evaluated with EORTC-30 tests( European organization for research and treatment of cancer,scores range from 0 to 100; a higher score represents a higher "better" level of functioning, or a higher "worse" level of symptoms | 12 months from surgery |
| Postoperative quality of life | The postoperative QOL was evaluated with EORTC-30 tests( European organization for research and treatment of cancer,scores range from 0 to 100; a higher score represents a higher "better" level of functioning, or a higher "worse" level of symptoms) | 6 years from surgery |
| Postoperative quality of life | The postoperative QOL was evaluated with EORTC-29 tests (European organization for research and treatment of cancer each question goes from 1 to 4 , the higher score defines worse symptoms) | 12 months from surgery |
| Postoperative quality of life | The postoperative QOL was evaluated with EORTC-29 tests (European organization for research and treatment of cancer each question goes from 1 to 4 , the higher score defines worse symptoms) | 6 years from surgery |
| Postoperative quality of life | The postoperative QOL was evaluated with EORTC-29 tests (European organization for research and treatment of cancer each question goes from 1 to 4 , the higher score defines worse symptoms) | 6 months from surgery |
| Postoperative quality of life | The postoperative QOL(quality of life) was evaluated with SF-36 score (Short form-36 score, each item scored from 0 to 100, the higher scores defines a favorable health state) | 6 months from surgery |
| Postoperative quality of life | The postoperative QOL was evaluated with SF-36 score (Short form-36 score, each item scored from 0 to 100, the higher scores defines a favorable health state) | 12 months from surgery |
| Postoperative quality of life | The postoperative QOL was evaluated with SF-36 score (Short form-36 score, each item scored from 0 to 100, the higher scores defines a favorable health state) | 6 years from surgery |
| Postoperative surgical complication | The incidence of postoperative surgical complications was evaluated | 1 month from surgery |
| ID | Term |
|---|---|
| D005242 | Fecal Incontinence |
| D003248 | Constipation |
| D000076385 | Diverticular Diseases |
| ID | Term |
|---|---|
| D012002 | Rectal Diseases |
| D007410 | Intestinal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D005759 | Gastroenteritis |
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