preserving inferior mesenteric artery during elective laparoscopic sigmoidectomy for diverticulitis

Context: during a laparoscopic sigmoid resection (lsr) for patients with diverticulitis, the inferior mesenteric artery may or may not be preserved depending on the surgical technique. we aimed to evaluate results after lsr with inferior mesenteric artery preservation (imap) and superior rectal artery preservation (srap) in terms of anastomotic leakages and denervation of the hypogastric nerves with consequent genitourinary and defecation alterations. evidence acquisition: a retrospective pubmed research of manuscripts published from january 2000 to january 2020 was conducted, enrolling studies about patients with symptomatic diverticular disease who underwent surgery. results: a total of 1685 patients with imap and srap were included in the study. conclusion: this retrospective review showed that patients with imap-srap demonstrated an equal or lower leakage rate with reduced incidence of stoma, lower incidence of defecation disorders, and similar or improved quality of life compared with laparoscopic left colectomy with no imap.