Matsuo Teppei, Otsuka Koki, Kimura Toshimoto, Yaegashi Mizunori, Takashimizu Kiyoharu, Hirata Yuichiro, Nakamura Yuya, Sasaki Akira
Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 idaidori yahaba, Iwate 028-3695, Japan.
Int J Surg Case Rep. 2021 Jan;78:307-309. doi: 10.1016/j.ijscr.2020.12.036. Epub 2020 Dec 17.
A 55-year-old-man underwent laparoscopic sigmoidectomy for sigmoid colon cancer. Preoperative barium enema showed a slightly medial displacement of the descending colon, and the sigmoid colon was quite long. The operative findings showed that the descending colon was not fused with the retroperitoneum and shifted to the midline and the left colon adhered to the small mesentery and right pelvic wall. Thus, a diagnosis of persistent descending mesocolon (PDM) was made. The left colon, sigmoid colon, and superior rectal arteries often branch radially from the inferior mesenteric artery. The sigmoid mesentery shortens, and the inferior mesenteric vein is often close to the marginal vessels. By understanding the anatomical feature of PDM and devising surgical techniques, laparoscopic sigmoidectomy for sigmoid colon cancer with PDM could be performed without compromising its curative effect and safety.
一名55岁男性因乙状结肠癌接受了腹腔镜乙状结肠切除术。术前钡灌肠显示降结肠轻度向内侧移位,乙状结肠很长。手术结果显示降结肠未与腹膜后融合并向中线移位,左结肠附着于小肠系膜和右盆腔壁。因此,诊断为持续性降结肠系膜(PDM)。左结肠、乙状结肠和直肠上动脉常从肠系膜下动脉呈放射状分支。乙状结肠系膜缩短,肠系膜下静脉常靠近边缘血管。通过了解PDM的解剖特征并设计手术技巧,可以在不影响其疗效和安全性的情况下对患有PDM的乙状结肠癌进行腹腔镜乙状结肠切除术。