Department of Surgery and Interventional Sciences, University College London Hospitals, NHS Trusts, 235 Euston Rd, Bloomsbury, London, NW1 2BU, UK.
GENIE Centre, University College London, London, UK.
Tech Coloproctol. 2017 Sep;21(9):757-760. doi: 10.1007/s10151-017-1677-x. Epub 2017 Aug 29.
Recent advances in mesenteric science have demonstrated that the mesentery is a continuous structure with a 'watershed' area at the mesenteric apex between the right colon and terminal ileum, where lymphatic flow can proceed either proximally or distally. With this new understanding of the anatomy, functional features are emerging, which can have an impact on surgical management. Fluorescence lymphangiography or lymphoscintigraphy with indocyanine green allows real-time visualization of lymphatic channels, which highlights sentinel lymph nodes and may facilitate identification of the ideal margins for mesenteric lymphadenectomy during bowel resection for colon cancer. By using this novel technology, it is possible to demonstrate a watershed area in the ileocolic region and may facilitate more precise mesenteric dissection. In the present study, we provide proof of concept for the ileocolic watershed area using fluorescence lymphangiography.
肠系膜科学的最新进展表明，肠系膜是一个连续的结构，在右结肠和末端回肠之间的肠系膜顶点有一个“分水岭”区域，淋巴液可以向近端或远端流动。有了对这种解剖结构的新认识，其功能特征也逐渐显现，这可能会对手术管理产生影响。荧光淋巴管造影或吲哚菁绿淋巴闪烁显像术可实时显示淋巴管，突出显示前哨淋巴结，并可能有助于在结肠癌肠切除术中确定肠系膜淋巴结清扫的理想边界。通过使用这项新技术，有可能证明回肠结肠区域存在分水岭，并可能更精确地进行肠系膜解剖。在本研究中，我们使用荧光淋巴管造影术为回肠结肠分水岭区域提供了概念验证。
