Low vs. high ligation of the inferior mesenteric artery during rectal cancer surgery shows no significant difference in anastomotic leakage rates.

• Anastomotic leakage occurred in 4.9% (low ligation) vs. 6.0% (high ligation); no significant difference (p=0.68).
• 30-day postoperative morbidity was 14.0% for low ligation vs. 22.0% for high ligation (p=0.08).

Surgeons can choose either ligation method without compromising patient outcomes.

• Long-term bowel function and other quality-of-life measures were similar across both groups.