Schwilden E D
Neth J Surg. 1983 Dec;35(5):167-72.
The radicular ligation of the inferior mesenteric artery close to the aorta, usual in surgery for rectosigmoid carcinoma, generally has no clinical consequences if the vascular anatomy is normal. However, owing to advanced age of the carcinoma patient, there may be coexistent stenosing arterio-sclerotic vessel wall lesions which are sometimes compensated through a collateral circulation originating from the inferior mesenteric artery. In that case, routine ligation of the inferior mesenteric artery may lead to a regression of the perfusion of the visceral organs or of the lower extremity, with the corresponding clinical consequences. The possibilities of preoperative determination of the contingent risks of the mesenteric artery ligation and their prevention and treatment are described.
在乙状结肠癌手术中,通常会在靠近主动脉处对肠系膜下动脉进行根部结扎。如果血管解剖结构正常,一般不会产生临床后果。然而,由于癌症患者年龄较大,可能同时存在动脉粥样硬化性血管壁狭窄病变,有时这些病变可通过源自肠系膜下动脉的侧支循环得到代偿。在这种情况下,常规结扎肠系膜下动脉可能会导致内脏器官或下肢灌注减少,从而产生相应的临床后果。本文描述了术前确定肠系膜动脉结扎可能风险及其预防和治疗的方法。