Usefulness of inferior mesenteric artery preservation in retroperitoneal lymph node dissection

Abstract

— In stage II and III non-seminomatous germ-cell testis tumor, retroperitoneal lymph node dissection is generally advised, often associated with systemic chemotherapy. Most Authors report ligature and section of the inferior mesenteric artery without any complication. We reviewed some papers by Valdoni and co-workers about preservation and peeling of the afore-mentioned artery in colo-rectal radical surgery; such procedure is technically feasible and oncologically reliable and ensures good perfusion of the descending colon, especially in the case of vascular anomalies (accessory left colic flexure artery, mono- or bilateral absence of middle rectal artery). In fact those patients subjected to retroperitoneal lymph node dissection may request colonic resection in the future; therefore preservation of the inferior mesenteric artery may represent an example of surgical foresight.