Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland.
International Evidence-Based Anatomy Working Group, Cracow, Poland.
Clin Anat. 2022 Oct;35(7):934-945. doi: 10.1002/ca.23898. Epub 2022 May 5.
The middle anorectal artery (MAA) is considered to supply the middle and lower parts of the rectum, however, its prevalence and point of origin vary across the literature. Clinical importance of the MAA becomes evident in the total mesorectal excision during the colorectal surgery of rectal cancer in both sexes, as well as interventional radiology procedures utilizing the prostatic vasculature in males. Major electronic medical databases were investigated for terms pertaining to the MAA and its associated variations. Compatible data regarding the artery's prevalence, laterality, origin, and distribution in both sexes was acquired. The risk of bias within the studies was assessed utilizing the AQUA tool. In total, 28 works (n = 880 patients/1905 pelvic sides) were included in this systematic review and meta-analysis, and their publication date ranged from 1897 until 2021. The overall pooled prevalence estimate for the MAA was 59.8% of the patients, and 55.2% of the pelvic sides studied. The vessel was identified more frequently in cadaveric pelvic sides evaluations (79.3%). The artery was found bilaterally more often (56.7%), and most commonly originated from the internal pudendal artery (50.3%). Anastomoses between the MAA and the other anorectal arteries were reported in 78.1%. The MAA is predominantly a present vessel, with various point of origin. Its direct clinical significance is yet to be discovered in larger study samples, providing more detailed and unified reports of its anatomical features, especially regarding its branches.
中间直肠动脉（MAA）被认为供应直肠的中下部，但它在文献中的出现率和起源点各不相同。在男性的直肠癌结直肠手术中进行全直肠系膜切除以及介入放射学程序利用前列腺血管时，MAA 的临床重要性变得明显。主要的电子医疗数据库都针对 MAA 及其相关变异进行了术语调查。获取了关于该动脉的流行率、侧别、起源和在两性中的分布的相关数据。使用 AQUA 工具评估研究中的偏倚风险。本系统评价和荟萃分析共纳入 28 项研究（n=880 名患者/1905 侧骨盆），其发表日期从 1897 年到 2021 年不等。MAA 的总体汇总流行率估计为 59.8%的患者和 55.2%的研究骨盆侧。该血管在尸体骨盆侧评估中更常被识别（79.3%）。该动脉更常双侧出现（56.7%），最常见起源于阴部内动脉（50.3%）。MAA 与其他直肠动脉之间的吻合支报告发生率为 78.1%。MAA 主要是一种存在的血管，具有不同的起源点。其直接临床意义尚未在更大的研究样本中发现，提供了关于其解剖特征的更详细和统一的报告，特别是关于其分支。
