Department of General Surgery & Institute of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Shenzhen University General Hospital & Shenzhen University Clinical Medical Academy, Xueyuan Road 1098, Shenzhen, 518055, China.
Carson International Cancer Center & Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Health Science Center, Xueyuan Road 1066, Shenzhen, 518060, China.
World J Surg Oncol. 2022 Sep 10;20(1):290. doi: 10.1186/s12957-022-02744-6.
Currently, high or low ligation of the inferior mesenteric artery (IMA) is a controversial issue in laparoscopic radical surgery for colorectal cancer. High or low ligation of the IMA has both advantages and disadvantages, and the level of ligation during the left colon and/or rectum resection has been a dilemma for surgeons. One important factor influencing the surgeon's decision to ligate the IMA in a high or low position is the anatomical type of the IMA and its branches. Some studies confirm that the anatomy of the IMA and its branches is critical to the anastomotic blood supply and, therefore, influences the choice of surgical approach (level of ligation of the IMA). However, many vascular variations in the anatomy of the IMA and its branches exist. Herein, we have summarized the anatomical types of the IMA and its branches, finding that the classification proposed by Yada et al. in 1997 is presently accepted by most scholars. Based on Yada's classification, we further summarized the characteristics of the IMA's various anatomical types as a guide for high or low ligation in radical colorectal cancer surgery.
目前，在腹腔镜结直肠癌根治术中，肠系膜下动脉（IMA）高位或低位结扎是一个有争议的问题。IMA 高位或低位结扎各有利弊，在左半结肠和/或直肠切除术中结扎的水平一直是外科医生的困境。影响外科医生决定在高位或低位结扎 IMA 的一个重要因素是 IMA 及其分支的解剖类型。一些研究证实，IMA 及其分支的解剖结构对吻合的血液供应至关重要，因此影响手术方法（IMA 结扎水平）的选择。然而，IMA 及其分支的解剖结构存在许多血管变异。在此，我们总结了 IMA 及其分支的解剖类型，发现 1997 年 Yada 等人提出的分类目前被大多数学者所接受。基于 Yada 的分类，我们进一步总结了 IMA 各种解剖类型的特点，作为指导结直肠癌根治术高低位结扎的依据。
