van Tonder J J, Boon J M, Becker J H R, van Schoor A-N
Department of Anatomy, Section of Clinical Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Clin Anat. 2007 May;20(4):424-7. doi: 10.1002/ca.20417.
Sudeck's critical point at the rectosigmoid junction is described as the point of origin of the last sigmoid arterial branch, originating from the inferior mesenteric artery (IMA). There is controversy on the importance of Sudeck's point, and the frequency in which the anastomosis is found. Furthermore, the diameter of the anastomosis, if present, may also impact on the viability of the caudal stump. This study aimed to determine the frequency in which a macroscopic anastomosis occurs, between the superior rectal artery and the last sigmoidal branch, in a cadaver population; the diameter of this anastomosis and the distance from the origin of the IMA to Sudeck's point. Sixty-four cadavers were included in the study, excluding those with previous surgery to the rectosigmoid junction. Sudeck's point was carefully identified and dissected to establish the presence of an anastomosis. Subsequent measurements were performed using a digital caliper (accuracy = 0.01 mm). A macroscopic anatomosis was absent in three cases (4.7%). The mean diameter of the anastomosis when present was 1.9 mm (SD: 0.5 mm), and the distance from the origin of the IMA to Sudeck's point was 55.5 mm (SD: 14.6 mm). Although an anastomosis is present in the majority of cases, the vessel is very small in diameter, and may not be sufficient to meet the demands of the caudal stump. The distance from the origin of the IMA to Sudeck's point is sufficient enough to allow for ligation of the IMA proximal to Sudeck's point.
直肠乙状结肠交界处的苏戴克临界点被描述为最后一个乙状结肠动脉分支的起始点，该分支起源于肠系膜下动脉（IMA）。关于苏戴克点的重要性以及发现吻合的频率存在争议。此外，若存在吻合，其直径也可能影响尾侧残端的活力。本研究旨在确定在尸体人群中，直肠上动脉与最后一个乙状结肠分支之间出现宏观吻合的频率；该吻合的直径以及从IMA起点到苏戴克点的距离。64具尸体纳入研究，排除之前有直肠乙状结肠交界处手术史的尸体。仔细识别并解剖苏戴克点以确定是否存在吻合。随后使用数字卡尺（精度 = 0.01毫米）进行测量。3例（4.7%）未发现宏观吻合。存在吻合时，吻合的平均直径为1.9毫米（标准差：0.5毫米），从IMA起点到苏戴克点的距离为55.5毫米（标准差：14.6毫米）。虽然大多数情况下存在吻合，但血管直径非常小，可能不足以满足尾侧残端的需求。从IMA起点到苏戴克点的距离足够长，足以在苏戴克点近端结扎IMA。
