Abstract: Abstract: Objective To compare the surgical effects and quality of life in patients with rectal cancer treated by lower ligation and high ligation of inferior mesenteric artery (IMA). Methods A total of 94 patients with rectal cancer were divid⁃ ed into low ligation group (low ligation of IMA, n=50) and high ligation group (high ligation of IMA, n=44) according to the li⁃ gation mode of IMA. The clinical data, incidence of operative complications and defecation function were compared between the two groups. The two groups of patients were followed up for 3 years after the operation. The tumor metastasis rate, recur⁃ rence rate, 3-year survival rate and scores of European organisation for research and treatment of cancer (EORTC) and quali⁃ ty of life questionnaire (QLQ-C30) were compared between two groups. Results (1)There were no significant differences in operation time, intraoperative blood loss, the number of dissected lymph nodes, the number of dissected IMA root lymph nodes and hospital stay between the two groups (P＞0.05). The anal exhaust time was shorter in low ligation group than that of high ligation group (P＜0.05). (2)The incidence of anastomotic leakage was lower in low ligation group than that of high li⁃ gation group (P＜0.05). There was no significant difference in the incidence of the other operative complications between two groups (P＞0.05). (3)The defecation function scores were increased at 3 months, 6 months and 1 year after operation in two groups (P＜0.05). The defecation function scores were better at 3 months and 6 months after operation in low ligation group than those in high ligation group (P＜0.05). (4)There were no significant differences in the 3-year overall survival rate, tumor metastasis rate and recurrence rate between the two groups (P＞0.05). (5)The quality of life scores were increased at 6 months, 1 year, 2 years and 3 years after operation in two groups (P＜0.05), and the quality of life score at 6 months after op⁃ eration was higher in the low ligation group than that of the high ligation group (P＜0.05). Conclusion The curative effect of low ligation of IMA is similar to that of high ligation of IMA in the treatment of rectal cancer. However, the former has little effect on the defecation function and can improve the short-term quality of life of patients.

Key words: rectal neoplasms, mesenteric artery, inferior, low ligation, high ligation, radical operation