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[结肠血管的外科解剖学(中文)及其对结肠代食管手术的影响]

[Surgical anatomy of the colic vessels in Chinese and its influence on the operation of esophageal replacement with colon].

作者信息

Cheng Bang-chang, Chang Sheng, Huang Jie, Mao Zhi-fu, Wang Zhi-wei, Lu Shi-qian, Wang Tu-sheng, Wu Xiao-jian, Hu Hao, Xia Jun, Kang Gan-jun, Xiao Yong-guang, Lin Hui-qing

机构信息

Department of Thoracic and Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2006 Jun 6;86(21):1453-6.

Abstract

OBJECTIVE

To investigate the configuration of colic vessels in Chinese and its influence on the operation of esophageal replacement with colon (ERC).

METHODS

The origin, trend, branching, configuration, and distribution of the colic vessels, the intensity of the colic arterial impulse, the integrity of the marginal artery at the splenic flexure and hepatic flexure of colon were observed during the operation of ERC among 582 patients undergoing ERC, 402 males mad 180 females, aged 2 approximately 74, from 22 provinces, municipality, and autonomous regions.

RESULTS

The left colic artery (LCA) stemmed from the inferior mesenteric artery (IMA) in 97.3% of the patients, with an absence rate of 0.7%. The middle colic artery (MCA) stemmed from the superior mesenteric artery (SMA) in 77.8% of the patients with an absence rate of 8.2%. Accessory middle colic artery (acMCA), originating from the right colic artery, could be seen in 6.2% of the patients 39.7% of the right colic artery (RCA) stemmed from the SMA by itself, 23.0% of the RMA stemmed together with MCA, and 28.0% of the RCA stemmed together with the ileocolic artery. The absence rate of RCA was 9.8%. The intactness rate of marginal artery was 96.8% at the splenic flexure of colon, and was 88.7% at the hepatic flexure. The Rolan arch was seen in only 7.6% of the patients.

CONCLUSION

The configuration of colic vessels in Chinese was basically similar to those of the results of autopsies carried out abroad. The optimal supply artery of colic segment during ERC is LCA, followed by LCA. Attention should be paid to the integrity of marginal arteries and veins in the patients with history of epigastric operation.

摘要

目的

探讨国人结肠血管的形态及其对结肠代食管术(ERC)手术的影响。

方法

在对来自22个省、直辖市和自治区的582例行ERC手术的患者(男性402例,女性180例,年龄2至74岁)进行手术过程中,观察结肠血管的起源、走行、分支、形态及分布,结肠动脉搏动强度,结肠脾曲和肝曲边缘动脉的完整性。

结果

97.3%的患者左结肠动脉(LCA)发自肠系膜下动脉(IMA),缺如率为0.7%。77.8%的患者中结肠动脉(MCA)发自肠系膜上动脉(SMA),缺如率为8.2%。6.2%的患者可见起自右结肠动脉的副中结肠动脉(acMCA)。39.7%的右结肠动脉(RCA)单独发自SMA,23.0%的RCA与MCA共干,28.0%的RCA与回结肠动脉共干。RCA缺如率为9.8%。结肠脾曲边缘动脉完整率为96.8%,肝曲为88.7%。仅7.6%的患者可见Rolan弓。

结论

国人结肠血管形态与国外尸检结果基本相似。ERC术中结肠段的最佳供血动脉为LCA,其次为RCA。对上腹部手术史患者应注意边缘动静脉的完整性。

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