The Second Department of Surgery, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, Hebei, People's Republic of China.
Sci Rep. 2024 Mar 24;14(1):6985. doi: 10.1038/s41598-024-57661-3.
To assess the anatomy of the inferior mesenteric artery (IMA) and its branches by reviewing laparoscopic left-sided colorectal cancer surgery videos and comparing them with preoperative three-dimensional computed tomography (3D-CT) angiography, to verify the accuracy of 3D-CT vascular reconstruction techniques. High-definition surgical videos and preoperative imaging data of 200 patients who underwent laparoscopic left-sided colorectal cancer surgery were analysed, and the alignment of the IMA and its branches in relation to the inferior mesenteric vein (IMV) was observed and summarized. The above two methods were used to measure the length of the IMA and its branches. Of 200 patients, 47.0% had the sigmoid arteries (SAs) arise from the common trunk with the superior rectal artery (SRA), and 30.5% had the SAs arise from the common trunk with the left colic artery (LCA). In 3.5% of patients, the SAs arising from both the LCA and SRA. The LCA, SA, and SRA emanated from the same point in 13.5% of patients, and the LCA was absent in 5.5% of patients. The range of D cm (IMA length measured by intraoperative silk thread) and d cm (IMA length measured by 3D-CT vascular reconstruction) in all cases was 1.84-6.62 cm and 1.85-6.52 cm, respectively, and there was a significant difference between them. (p < 0.001). The lengths between the intersection of the LCA and IMV measured intraoperatively were 0.64-4.29 cm, 0.87-4.35 cm, 1.32-4.28 cm and 1.65-3.69 cm in types 1A, 1B, 1C, and 2, respectively, and there was no significant difference between the groups (p = 0.994). There was only a significant difference in the length of the IMA between the 3D-CT vascular reconstruction and intraoperative observation data, which can provide guidance to surgeons in preoperative preparation.
评估肠系膜下动脉（IMA）及其分支的解剖结构，通过回顾腹腔镜左半结直肠癌手术视频，并与术前三维 CT（3D-CT）血管造影相比较，验证 3D-CT 血管重建技术的准确性。分析了 200 例行腹腔镜左半结直肠癌手术患者的高清手术视频和术前影像学资料，观察并总结了 IMA 及其分支与肠系膜下静脉（IMV）的关系。以上两种方法均用于测量 IMA 及其分支的长度。200 例患者中，47.0%的患者乙状动脉（SA）与直肠上动脉（SRA）共干起源，30.5%的患者 SA 与左结肠动脉（LCA）共干起源。3.5%的患者 SA 同时起源于 LCA 和 SRA。13.5%的患者 LCA、SA 和 SRA 从同一部位发出，5.5%的患者 LCA 缺失。术中丝线测量的 IMA 长度 Dcm（IMA 长度）和 3D-CT 血管重建测量的 IMA 长度 dcm（IMA 长度）在所有病例中的范围分别为 1.84-6.62cm 和 1.85-6.52cm，两者之间存在显著差异（p<0.001）。术中测量 LCA 与 IMV 交点的长度分别为 0.64-4.29cm、0.87-4.35cm、1.32-4.28cm 和 1.65-3.69cm，分别为 1A、1B、1C 和 2 型，各组间差异无统计学意义（p=0.994）。只有 3D-CT 血管重建与术中观察数据之间的 IMA 长度存在显著差异，这可为术前准备提供指导。
