Cheng B C
Zhonghua Wai Ke Za Zhi. 1989 Sep;27(9):566-8, 575-6.
In 162 cases of esophageal replacement by colon we observed the configuration, distribution and pulsation of the middle, left, right and marginal colic arteries. Observation showed that the middle colic artery had only one major stem in 120 cases, 2-4 branches in 37 cases, and was absent in 5 cases. The middle colic artery originated from the superior mesenteric artery in 126 cases, had one stem originating from the superior mesenteric artery and another from the right colic artery in 10 cases. The middle and the right colic arteries forming one stem and originating from the superior mesenteric artery were seen in 21 cases. The distributive patterns of the middle colic arteries showing "T" type was seen in 37 cases, "V" type in 28 cases, and multiple paralleled branches in 9 cases. Vascular anastomoses between the ascending branch of the left colic artery and the middle colic artery were available in 157 cases (97%), 12 cases with the arc of Riolan. The nearest distance between the marginal artery and the colic wall was at the splenic flexure. The origin of the right colic artery varied greatly and its distributive area was small. We advocated the use of the ascending branch of the left colic artery for blood supply and the transverse colon for replacement of the esophagus in an isoperistaltic fashion (131/162 cases) to be the procedure of choice.
在162例结肠代食管病例中,我们观察了中结肠动脉、左结肠动脉、右结肠动脉和边缘结肠动脉的形态、分布及搏动情况。观察发现,120例中结肠动脉仅有1个主干,37例有2 - 4个分支,5例缺如。126例中结肠动脉起自肠系膜上动脉,10例1个主干起自肠系膜上动脉,另1个起自右结肠动脉。21例中结肠动脉与右结肠动脉合成1干起自肠系膜上动脉。中结肠动脉分布呈“T”型者37例,“V”型者28例,多支平行分支者9例。157例(97%)左结肠动脉升支与中结肠动脉有血管吻合,12例有Riolan弓。边缘动脉与结肠壁的最近距离在脾曲处。右结肠动脉起源变异较大,分布范围小。我们主张以左结肠动脉升支供血,顺蠕动用横结肠代食管(131/162例)为首选术式。