Siddharth P, Smith N L
Surg Gynecol Obstet. 1981 Jul;153(1):71-3.
According to standard practice, the inferior mesenteric artery, when sacrificed, should always be ligated at its origin, proximal to the left colic branch. However, it should not be sacrificed and ligated but instead, be reimplanted if any doubt exists regarding the adequacy of the collateral circulation. The patient is in a high risk category for development of ischemia of the colon if there is an occlusion or absence of the marginal artery at the splenic flexure; absence of the middle colic artery; occlusion of one or both hypogastric arteries, or enlargement of the left colic artery, suggesting occlusion of the superior mesenteric artery.
按照标准操作，肠系膜下动脉若需切除，应始终在其起始处、左结肠支近端进行结扎。然而，如果对侧支循环的充足性存在任何疑问，不应切除并结扎该动脉，而应进行再植。如果脾曲处边缘动脉闭塞或缺失；中结肠动脉缺如；一条或两条髂内动脉闭塞，或左结肠动脉增粗提示肠系膜上动脉闭塞，则患者发生结肠缺血的风险较高。
