scholarly journals Curative Surgery for Three Cases of Colorectal Cancer. Branching Variation with Middle Colic Artery Arising from the Inferior Mesenteric Artery.

1998 ◽  
Vol 51 (3) ◽  
pp. 183-188
Author(s):  
H. Yada ◽  
K. Sawai ◽  
H. Taniguchi ◽  
T. Takahashi ◽  
H. Izumi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Curative Surgery

scholarly journals A three-dimensional computed tomography angiography study of the anatomy of the accessory middle colic artery and implications for colorectal cancer surgery

2020 ◽  
Vol 42 (12) ◽  
pp. 1509-1515
Author(s):  
Mitsuhiro Yano ◽  
Shinji Okazaki ◽  
Ichiro Kawamura ◽  
Shunichiro Ito ◽  
Shintaro Nozu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Three Dimensional ◽  
Middle Colic Artery ◽  
Inferior Mesenteric Vein ◽  
Colic Artery ◽  
Left Colic Artery ◽  
Colorectal Cancer Surgery

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.

scholarly journals Course and Variations in Branches of Inferior Mesenteric Artery

2021 ◽  
Vol 9 (1) ◽  
pp. 17-20
Author(s):  
Prerna Gupta ◽  
Neeraj Gupta
Keyword(s):  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Mesenteric Arteries ◽  
Middle Colic Artery ◽  
Type I ◽  
Colic Artery ◽  
Male Fetus ◽  
Male Adult ◽  
Female Fetus ◽  
Study Results

Background : The mesenteric blood supply is a combination of rich collateral networks. There are frequent anatomical variants encountered and these variations are sometimes involved in pathologies. Treatment of which requires a better understanding of the variations in the normal anatomy of the inferior mesenteric artery. Methods : The present study was carried out in the Department of Anatomy, Prathima Institute of Medical Sciences, Karimnagar. A total of n=50 specimens, with n=17 adult males and n=2 adult female cadavers and fetuses of which n=26 were term and n=2, was preterm. Female fetuses n=2 of term and n=1 preterm were included in the study. Results : The following variations were observed in the present study of course and variations in the branches of the inferior mesenteric artery and are grouped into three types. Type I: In this type middle colic artery is arising from the inferior mesenteric artery instead of the superior mesenteric artery. It is a rare-variations and observed in a female fetus. Type-II: Four Sigmoidal arteries are arising from an inferior mesenteric artery, after the origin of the left colic artery. This type is observed in a male fetus. Type-III: Three Sigmoidal arteries are originated from the inferior mesenteric artery. This type was observed in a male adult and a male fetus. Conclusion: Out of the 50 cases included in the study we found type 1 variation of IMA in 2% of cases, type 2 variation was found in 2% samples, and type 3 variation was found in 4% of samples. Based on the variations radiologists and Surgeons should be aware of possible consequences when doing colectomy, right hemicolectomy, left hemicolectomy, sigmoidectomy, en-bloc resection of the head of the pancreas, aneurysm, and chronic bowel ischemia. The present study is also useful for reconstructive surgeries in inferior mesenteric arteries in the case of ischemia.

scholarly journals The New Concept of Physiological “Riolan’s Arch” and the Reconstruction Mechanism of Pathological Riolan’s Arch After High Ligation of the Inferior Mesenteric Artery by CT Angiography-Based Small Vessel Imaging

2021 ◽  
Vol 12 ◽  
Author(s):  
Ying Wang ◽  
Weibin Shu ◽  
Aimie Ouyang ◽  
Lei Wang ◽  
Yuping Sun ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Splenic Flexure ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Three Dimensional ◽  
High Ligation ◽  
Colic Artery ◽  
Left Colic Artery ◽  
Pathological Conditions ◽  
Anatomical Classification

BackgroundDue to the complexity of anatomical relationship between superior mesenteric artery (SMA) and left colic artery (LCA), there is no unified anatomical concept of “Riolan’s arch.” There is no consensus as to tie off the inferior mesenteric artery (IMA) at its origin or just below the origin of the left colic artery during radical surgery of sigmoid colon and rectal cancers. The aim of the study is to investigate the anatomy of shortcut anastomotic branches (adjacent branches) of SMA at splenic flexure and to explore how the shortcut pathway (Riolan’s arch) was formed, as the compensation of anastomotic branches between MCA and LCA under pathological conditions and the reconstruction and the mechanism of pathological Riolan’s arch after high ligation of the inferior mesenteric artery.MethodsBetween January 2018 and May 2020, patients with colorectal cancer who underwent CTA before surgery were enrolled in the study. The anatomy of shortcut anastomotic branch of SMA and LCA was investigated by volume rendering technique (VR) and maximum-intensity projection (MIP). GE’s small vessel extraction technology (selected VR) was used to directly display these shortcut anastomotic branches on a map and to establish their three-dimensional anatomical classification. Then, we used the axonometric drawing to make the model more exact. Next, combining with some cases of pathological Riolan’s arch and basing on hydrodynamic principle, we speculate the mechanism of collateral circulation. Finally, based on the retrospective study of high ligation cases and combined principles of fluid mechanics, we show how these shortcut anastomotic branches evolved into Riolan’s arch.ResultsWe report the classification of the ascending branch of LCA (which approaches the splenic flexure) and the left branch of MCA, display these shortcut anastomotic branches on a map, and establish their three-dimensional anatomical classification. We found that Riolan’s arch is a shortcut pathway for the compensation of anastomotic branches, between MCA and LCA under pathological conditions, and that the formation mechanism of shortcut path accords with the principle of hydrodynamics.ConclusionsOur results show the mechanism of pathological Riolan’s arch formation and provide new anatomic thinking for the battle between high and low ligation of IMA in colorectal cancer surgery.

scholarly journals Anatomical Study of Variations in the Branches of Superior Mesenteric Artery – A Study from a Teaching Hospital in Chennai, India

2021 ◽  
Vol 10 (20) ◽  
pp. 1506-1510
Author(s):  
Ganga Venkatachalam ◽  
Kanagavalli Paramasivam ◽  
Lakshmi Valliyappan
Keyword(s):  
Superior Mesenteric Artery ◽  
Abdominal Aorta ◽  
Mesenteric Artery ◽  
Lumbar Vertebra ◽  
Anatomical Study ◽  
Middle Colic Artery ◽  
Branching Pattern ◽  
Colic Artery ◽  
Human Cadavers ◽  
Derivatives Of

BACKGROUND Superior Mesenteric Artery (SMA) is one of the anterior branches of the abdominal aorta. It originates from abdominal aorta at the level of lower border of first lumbar vertebra, one centimeter below the coeliac trunk. It gives the first branch inferior pancreaticoduodenal artery (IPDA), The colic branches arise from concave right side of the superior mesenteric artery, these are middle colic artery (MCA), right colic artery (RCA), ileo colic artery (ICA). Jejunal and ileal branches arise from left side of the SMA. Superior mesenteric artery supplies derivatives of midgut. Knowledge of branching pattern of the SMA is clinically important to gastroenterologists operating on gut and neighboring structures like pancreas, duodenum, and liver. We wanted to study the variations in the branches of superior mesenteric artery. METHODS This is a descriptive study conducted on 50 adult embalmed human cadavers by conventional dissection method, the findings were noted and tabulated. RESULTS Present study shows that inferior pancreatic duodenal artery orginated from SMA in 47 (94 %) specimens. IPDA was absent in 3 (6 %) specimens. Middle colic artery was found to arise from SMA in 48 (94 %) and MCA was absent in 2 (4 %) specimens. Right colic artery was found to arise from SMA in 47 (94 %) specimens and it was absent in 3 (6 %) specimens. Ileo-colic artery was found to arise from SMA in all 50 (100 %) specimens. CONCLUSIONS Awareness of these complex variations may prevent devastating complications during colonic surgeries. Variations in the branching pattern of superior mesenteric artery is essential for surgeons operating on derivatives of midgut, liver, pancreas. KEY WORDS Branches, Colic, Superior Mesenteric Artery, Variations

scholarly journals High tie versus low tie of the inferior mesenteric artery in colorectal cancer: A meta-analysis

2018 ◽  
Vol 52 ◽  
pp. 20-24 ◽  
Author(s):  
Yafan Yang ◽  
Guiying Wang ◽  
Jingli He ◽  
Jianfeng Zhang ◽  
Jinchuan Xi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Meta Analysis ◽  
High Tie ◽  
Low Tie

Outcomes of level of ligation of inferior mesenteric artery in colorectal cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Pavan Kumar Jonnada ◽  
Monish Karunakaran ◽  
Dayakar Rao
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Anastomotic Leak ◽  
Mesenteric Artery ◽  
Fixed Effects ◽  
Inferior Mesenteric Artery ◽  
Meta Analysis ◽  
High Ligation ◽  
Recurrence Rates ◽  
Low Ligation

The level of ligation of the inferior mesenteric artery (IMA) is a critical factor that can influence outcomes. The aim of this meta-analysis was to compare outcomes following high or low ligation of IMA. A systematic search was performed for relevant articles published between 2000 and 2020. Meta-analysis was performed using fixed-effects or random-effects models; 31 studies were included. Results show significantly lower rates of anastomotic leak, postoperative morbidity and urinary dysfunction with low ligation compared with high ligation. Though recurrence rates were similar, 5-year overall survival was longer in the low ligation group. Low ligation of IMA decreases anastomotic leak rates and overall morbidity. Addition of IMA nodal clearance to low ligation appears to improve overall survival in colorectal cancer.

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