CASE SERIES: RECTOSIGMOIDECTOMY AFTER DIVERTICULITIS CRISIS WITH PRESERVATION OF LEFT COLIC AND SUPERIOR RECTAL ARTERIES

Introduction Colon resections involve various aspects that determine a satisfactory outcome. Among the numerous complications related to the surgical procedure, anastomotic dehiscence is undoubtedly one of the most feared by surgeons. One of the factors that directly impacts the success of the anastomosis is local blood supply. As a result, vascular ligations have become increasingly conservative to maintain adequate blood flow to the remaining colon and, most importantly, to the anastomosed region. The preservation of the left colic and superior rectal arteries during rectosigmoidectomy has been widely practiced with satisfactory results, including in the restoration of early intestinal transit.

Objective To report a series of cases of patients who underwent rectosigmoidectomy after diverticulitis crises, where the left colic and superior rectal arteries were preserved, showing the technique used through video.

Method All patients who underwent laparoscopic rectosigmoidectomy due to diverticulitis crises were cataloged. Medical records were reviewed to obtain data and calculate results, followed by video editing of one of the procedures, illustrating the main steps of the surgery.

Result A total of 15 patients were operated on between January 2023 and June 2024. Of the 15 patients, 8 were female and 7 were male, with an average age of 59.3 years. Four patients presented with paralytic ileus, and the other 11 had restored intestinal transit within 4 days. There was no anastomotic dehiscence or need for reoperation in the analyzed sample. The average hospital stay was 7.25 days.

Conclusion The strategy of preserving the left colic and superior rectal arteries is valid, yields good results, and improves blood supply at the anastomotic level, reducing the risk of local ischemia and, consequently, anastomotic dehiscence. The restoration of intestinal function and hospital discharge time were similar to the data found in the global literature.

Publication History

Article published online:
25 April 2025