[Secondary circulatory disorders following rectosigmoid resection]

The radicular ligation of the inferior mesenteric artery close to the aorta, usual in surgery for rectosigmoid carcinoma, generally has no clinical consequences if the vascular anatomy is normal. However, owing to advanced age of the carcinoma patient, there may be coexistent stenosing arterio-sclerotic vessel wall lesions which are sometimes compensated through a collateral circulation originating from the inferior mesenteric artery. In that case, routine ligation of the inferior mesenteric artery may lead to a regression of the perfusion of the visceral organs or of the lower extremity, with the corresponding clinical consequences. The possibilities of preoperative determination of the contingent risks of the mesenteric artery ligation and their prevention and treatment are described.