A three-dimensional computed tomography angiography study of the anatomy of the accessory middle colic artery and implic
- PDF / 843,867 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 0 Downloads / 190 Views
ORIGINAL ARTICLE
A three‑dimensional computed tomography angiography study of the anatomy of the accessory middle colic artery and implications for colorectal cancer surgery Mitsuhiro Yano1 · Shinji Okazaki1 · Ichiro Kawamura1 · Shunichiro Ito1 · Shintaro Nozu1 · Yuya Ashitomi1 · Takefumi Suzuki1 · Yukinori Kamio1 · Osamu Hachiya1 Received: 29 November 2019 / Accepted: 29 May 2020 © The Author(s) 2020
Abstract Purpose In the present study, we focused on the accessory middle colic artery and aimed to increase the safety and curative value of colorectal cancer surgery by investigating the artery course and branching patterns. Methods We included 143 cases (mean age, 70.4 ± 11.2 years; 86 males) that had undergone surgery for neoplastic large intestinal lesions at the First Department of Surgery at Yamagata University Hospital between August 2015 and July 2018. We constructed three-dimensional (3D) computed tomography (CT) angiograms and fused them with reconstructions of the large intestines. We investigated the prevalence of the accessory middle colic artery, the variability of its origin, and the prevalence and anatomy of the arteries accompanying the inferior mesenteric vein at the same level as the origin of the inferior mesenteric artery. Results Accessory middle colic artery was observed in 48.9% (70/143) cases. This arose from the superior mesenteric artery in 47, from the inferior mesenteric artery in 21, and from the celiac artery in two cases. In 78.2% (112/143) cases, an artery accompanying the inferior mesenteric vein was present at the same level as the origin of the inferior mesenteric artery; this artery was the left colic artery in 92, the accessory middle colic artery in 11, and it divided and became the left colic artery and the accessory middle colic artery in 10 cases. Conclusion 3D CT angiograms are useful for preoperative evaluation. Accessory middle colic arteries exist and were observed in 14.9% of cases. Keywords Colorectal cancer · Laparoscopic surgery · Middle colic artery · Transverse colon · Inferior mesenteric artery · Splenic flexure
Introduction In colorectal cancer surgery, it is essential to dissect the regional lymph nodes to an extent proportional to the stage of the tumor being resected [29]. It is exceedingly important to identify the feeding vessels of the tumor so that the region to be dissected can be determined. The use of laparoscopic navigation in colorectal cancer has been increasing in recent years with the popularization of laparoscopic surgery. * Mitsuhiro Yano m‑[email protected]‑u.ac.jp 1
Department of Gastroenterological, General, Breast and Thyroid Surgery, Faculty of Medicine, Yamagata University, Yamagata 990‑9585, Japan
Several studies report the advantages of laparoscopic surgery, such as reduced pain because of a smaller incision, earlier recovery of peristalsis, and shorter hospital stays [11, 27]. Laparoscopic surgery also enables more precise manipulation owing to magnification and closer proximity. Still, the narrow field of view and lack
Data Loading...
