The ligation site of the inferior mesenteric artery (IMA) during laparoscopic radical resection for rectal cancer has been controversial. Consecutive patients (n = 205) with rectal cancer who underwent laparoscopic-assisted low anterior resection from January 2009 to December 2015 were retrospectively analyzed. The patients were divided into high ligation (n = 126) and improved low ligation groups (n = 79). A total of 205 rectal cancer patients underwent laparoscopic assisted anterior resection: 126 patients in the high ligation group and 79 patients in the improved low ligation group. The improved low ligation group was better than the high ligation group in terms of postoperative flatus time and postoperative defecation time. There were no differences between the groups in terms of blood loss, operation time, total number of lymph nodes, anastomotic leakage, postoperative time to first liquid diet and postoperative hospital stay. There were also no differences in 5-year overall survival (OS). Compared to high ligation, the improved low ligation ensures the extent of lymph node dissection, and promotes the early recovery of postoperative gastrointestinal function, but does not increase the operation time, bleeding risk, or anastomotic leakage. A ligation site of the IMA in laparoscopic rectal cancer surgery may not influence oncological outcomes.

腹腔镜直肠癌根治术中肠系膜下动脉（IMA）的结扎部位一直存在争议。回顾性分析了 2009 年 1 月至 2015 年 12 月接受腹腔镜辅助低位前切除术的连续直肠癌患者（n = 205）。将患者分为高位结扎组（n = 126）和改良低位结扎组（n = 79）。共205例直肠癌患者行腹腔镜辅助前切除术：高位结扎组126例，改良低位结扎组79例。改良低位结扎组在术后排气时间和术后排便时间方面优于高位结扎组。两组在失血量、手术时间、淋巴结总数、吻合口瘘、术后首次流质饮食时间和术后住院时间。5 年总生存率 (OS) 也没有差异。与高位结扎相比，改良的低位结扎保证了淋巴结清扫的范围，促进了术后胃肠功能的早期恢复，但不增加手术时间、出血风险、吻合口漏。腹腔镜直肠癌手术中 IMA 的结扎部位可能不会影响肿瘤学结果。但不会增加手术时间、出血风险或吻合口漏。腹腔镜直肠癌手术中 IMA 的结扎部位可能不会影响肿瘤学结果。但不会增加手术时间、出血风险或吻合口漏。腹腔镜直肠癌手术中 IMA 的结扎部位可能不会影响肿瘤学结果。