Abstract

Background

It is important for lymph node dissection around the inferior mesenteric artery (IMA) with preservation of the left colic artery (LCA) to be aware of the track and the length of the LCA. We aimed to investigate the branching pattern and trajectory of LCA and measure the distances from the root of the IMA to the origin of the LCA (D mm) and from the origin of LCA to intersection of LCA and IMV (d mm) during laparoscopic left-sided colorectal operations.

Methods

We analyzed 106 patients who underwent laparoscope-assisted left-side colorectal surgery during laparoscopic surgery. The branching patterns among the IMA, LCA, and sigmoidal trunk were evaluated; the trajectory of LCA was examined; the D mm and d mm were measured using a length of silk in the surgical operation.

Results

In 59.5% patients, the LCA arose independently from the sigmoidal trunk (type A); in 8.5% patients, the LCA and sigmoidal trunk arose from the IMA at the same point (type B); in 29.2% patients, the LCA and sigmoidal trunk had a common trunk (type C); the LCA did not exist in 2.8% (type D).The D mm and d mm for all cases ranged from 15.0 to 65.3 mm (median, 43.1 mm) and from 20.3 to 46.2 mm (median, 34.8 mm), respectively. 74.8% of the LCA went straight upper left and upward to proximal part of descending colon (type I), 25.2% went to the lower left at first, then turned to travel straight upward to proximal part of descending colon (type II).

Conclusion

This study showed the anatomic variations of LCA during laparoscopic left-sided colorectal operation, which would help surgeons safely perform laparoscopic surgery in the left-side colon and rectum.

中文翻译：

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腹腔镜辅助结直​​肠手术中左结肠动脉的解剖学研究

摘要

背景

重要的是，要保留左结肠动脉（LCA），以保护肠系膜下动脉（IMA）周围的淋巴结清扫，了解LCA的轨迹和长度。我们的目的是调查腹腔镜左腹腔镜下LCA的分支模式和轨迹，并测量从IMA的根部到LCA的原点（D mm）以及从LCA的原点到LCA与IMV的交点的距离（d mm）。侧结直肠手术。

方法

我们分析了106例在腹腔镜手术期间接受了腹腔镜辅助的左侧结直肠手术的患者。评估了IMA，LCA和乙状干之间的分支模式；检查了LCA的轨迹；的d毫米和d毫米用在外科手术丝的长度测量。

结果

在59.5％的患者中，LCA的产生独立于乙状干（A型）。在8.5％的患者中，LCA和乙状结肠是由IMA在同一点（B型）引起的；在29.2％的患者中，LCA和乙状结肠具有共同的躯干（C型）。LCA在2.8％（D型）中不存在。所有情况下的D mm和d mm分别为15.0至65.3 mm（中位数43.1 mm）和20.3至46.2 mm（中位数34.8 mm）。LCA的74.8％一直笔直地从左上方向上延伸到降结肠的近端部分（I型），首先有25.2％的LCA到达左下角，然后转向笔直向上移动到降结肠的近端部分（II型）。

结论

这项研究显示了腹腔镜左侧结直肠手术中LCA的解剖学变化，这将有助于外科医生在左侧结肠和直肠中安全地进行腹腔镜手术。