Ligation of the inferior mesenteric artery in the surgery of rectal cancer: Anatomical considerations
Ligation of the inferior mesenteric artery in the surgery of rectal cancer: Anatomical considerations
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DOI：
10.1159/000077347
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发表时间：
2004-01-01
影响因子：
2.7
通讯作者：
Poli, MD
中科院分区：
文献类型：
--
作者：
Nano, M;Dal Corso, H;Poli, MD
背景资料：在直肠癌手术中，为了避免神经损伤，肠系膜下动脉（ima）结扎的最安全点在文献中没有一致的意见。研究设计：测量ima起点与左主动脉旁干之间的距离，以及左主动脉旁干与左结肠动脉起点之间的距离。在20具尸体和22例直肠癌手术中进行了测量。结果如下：左主动脉旁干总是走在ima的后面：它与ima起点的距离平均为1.2 cm;左主动脉旁干与lca起点的距离平均为0.4 cm。IMA和左主动脉旁干交叉点的位置变化很大，但绝不会靠近IMA的起点。结论：从解剖学的角度来看，最安全的结扎点是在其起源处。此时，左主动脉旁干不会走行，因此在结扎动脉的过程中不会有任何损伤神经的风险。版权所有（C）2004 S. Karger AG，巴塞尔。
Background: No agreement has been found in the literature concerning the safest point of ligation of the inferior mesenteric artery (ima) in order to avoid nerve damage during the surgery of rectal cancer. Study Design: The distance between the origin of the ima and the left paraortic trunk was measured, as was the distance between the left paraortic trunk and the origin of the left colic artery (lca). The measurements were carried out on 20 cadavers and during 22 operations for rectal cancer. Results: The left paraortic trunk always runs posterior to the ima: its distance from the origin of the ima is on average 1.2 cm; the distance of the left paraortic trunk from the origin of the lca is on average 0.4 cm. The point at which the ima and the left paraortic trunk cross varies greatly, but it is never near the origin of the ima. Conclusions: From an anatomical point of view the safest point of ligation of the ima is at its origin. At this point, the left paraortic trunk never runs; so there isn't any risk to damage the nerve involving it during the ligation of the artery. Copyright (C) 2004 S. Karger AG, Basel.