Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 49
Filtrar
1.
Int. j. morphol ; 41(2): 505-511, abr. 2023. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1440296

RESUMO

Las arterias sigmoideas son ramas de la arteria mesentérica inferior e irrigan al colon sigmoideo. Se originan del tronco de las arterias sigmoideas. Esta es la descripción más frecuente según los autores consultados. El objetivo fue analizar las variaciones en el origen y distribución de las arterias sigmoideas mediante disección. Se utilizaron 13 preparados cadavéricos formolizados al 10 %. Se disecó la cavidad abdominal para identificar a las arterias sigmoideas. Se evidenció su bifurcación paralela al colon sigmoideo. Se lo delimitó mediante reparos palpables. Patrón I: 4 casos (30,8 %). Variante de la arcada sigmoidea como rama colateral de la arteria mesentérica inferior. Tipo Ia: 1 caso (25 %). Sin asociaciones. Tipo Ib: 1 caso (25 %). Asociada al tronco sigmoideo. Tipo Ic: 2 casos (50 %). Asociada a arterias sigmoideas accesorias. Patrón II: 6 casos (46,2 %). Variante del tronco común entre arteria cólica izquierda y arterias destinadas al colon sigmoideo. Tipo IIa: 3 casos (50 %). Sin asociaciones. Tipo IIb: 2 casos (33,3 %). Asociado al tronco sigmoideo. Tipo IIc: 1 caso (16,7 %). Asociado a arterias sigmoideas accesorias. Patrón III: 3 casos (23 %). Variante clásica. Se definió por la ausencia del tronco común con la arteria cólica izquierda y de la arcada sigmoidea. Tipo IIIa: 2 casos (66,7 %). Un número variable de arterias sigmoideas nacen como ramas colaterales de la arteria mesentérica inferior, sin asociarse al tronco sigmoideo. Tipo IIIb: 1 caso (33,3 %). La arteria cólica izquierda emite como rama colateral la primera arteria sigmoidea y se asocia al tronco sigmoideo. 1. El patrón II es el prevalente en este trabajo (46,2 %). 2. La variante clásica no es la predominante en esta investigación (23 %). 3. La arcada sigmoidea tiene 53,8 % de incidencia.


SUMMARY: The sigmoid arteries are branches of the inferior mesenteric artery and supply the sigmoid colon. They originate from the trunk of the sigmoids. This is the most frequent description according to the consulted authors. The objective is to analyze the variations in the origin and distribution of the sigmoid arteries through dissection. 13 cadaveric preparations formalized at 10 % and instruments were used. The abdominal cavity was dissected to identify the sigmoid arteries. Its bifurcation parallel to the sigmoid colon is evident. It is delimited by palpable repairs. Pattern I: 4 cases (30.8 %). Variant of the sigmoid arcade as a collateral branch of the inferior mesenteric artery. Type Ia: 1 case (25 %). No associations. Type Ib: 1 case (25 %). Associated with the sigmoid trunk. Type Ic: 2 cases (50 %). Associated with accessory sigmoid arteries. Pattern II: 6 cases (46.2 %). Variant of the common trunk between the left colic artery and arteries destined for the sigmoid colon. Type IIa: 3 cases (50 %). No associations. Type IIb: 2 cases (33.3 %). Associated with the sigmoid trunk. Type IIc: 1 case (16.7 %). Associated with accessory sigmoid arteries. Pattern III: 3 cases (23 %). Classic variant. It was defined by the absence of the common trunk with the left colic artery and the sigmoid arcade. Type IIIa: 2 cases (66.7 %). A variable number of sigmoid arteries arise as collateral branches of the inferior mesenteric artery, without being associated with the sigmoid trunk. Type IIIb: 1 case (33.3 %). The left colic artery gives off the first sigmoid artery as a collateral branch and is associated with the sigmoid trunk. 1. Pattern II is the most prevalent in this study (46.2 %). 2. The classic variant is not the predominant one in this research (23 %). 3. The sigmoid arcade has a 53.8 % incidence.


Assuntos
Humanos , Masculino , Feminino , Colo Sigmoide/irrigação sanguínea , Artéria Mesentérica Inferior/anatomia & histologia , Cadáver
2.
Khirurgiia (Mosk) ; (9): 40-49, 2022.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-36073582

RESUMO

BACKGROUND: The inferior mesenteric artery (IMA) is a blood vessel of great importance in left colon and rectal cancer surgery. We aimed to determine the role of surgeons in computed tomography (CT) based vascular anatomy interpretation. METHOD: Patients with left colon and rectal cancer treated surgically with D3 lymph node dissection and selective vascular ligation were included in this study. All patients (n=250) underwent preoperative CT with intravenous contrast. The IMA anatomy was schematically depicted by surgeon based on CT interpretation. Intraoperatively anatomy was defined by skeletonisation of the IMA. All patients had segmental resection with selective vascular ligation. The concurrence of prospectively obtained results were evaluated by intraclass correlation and Kendall's tau-b test. Misinterpretation of IMA anatomy was analysed by CT-specialist. RESULTS: The preoperative and intraoperative IMA anatomy features were correctly interpreted in 237 cases (in 94.8%) within skeletonisation extent, which is supported by high level of agreement and concordance of preoperative data regards to intraoperative findings (K=0.926; p<0.001; CC=0.912; p<0.001). As a result of the CT-based evaluation of the IMA, E, K, and H types of branching patterns were proposed. IMV position was mistakenly identified in 2.6% of cases. CONCLUSION: Surgeons are able to evaluate the IMA anatomy accurately with CT and use it in routine preoperative planning. The E, K, and H branching types may be used when defining approach to skeletonisation and level of vascular ligation.


Assuntos
Laparoscopia , Neoplasias Retais , Cirurgiões , Humanos , Laparoscopia/métodos , Artéria Mesentérica Inferior/anatomia & histologia , Artéria Mesentérica Inferior/diagnóstico por imagem , Artéria Mesentérica Inferior/cirurgia , Neoplasias Retais/cirurgia , Tomografia Computadorizada por Raios X
3.
Surg Radiol Anat ; 44(5): 697-701, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35543749

RESUMO

PURPOSE: The literature reports the presence of the intermesenteric artery (IA), an anastomosis connecting the superior mesenteric artery (SMA) to the inferior mesenteric artery (IMA) in 9-18% of human cadaver dissections. This is the first study describing the morphological and demographic characteristics of the IA based on in vivo imaging. METHODS: A total of 150 consecutive abdominal computed tomography (CT) angiographies of adult patients identified by sex and age were analyzed. The IA was assessed for its presence, point of origin, pathway, point of insertion, and diameter at its origin. The diameters of the SMA, IMA, and other arteries from which the IA originated and into which it inserted were measured by CT angiography using Radiant™ and Osirix MD™ software. RESULTS: The IA was found in 17 (51.5%) of the females and 60 (51.3%) of the males. The diameters of the SMA and IMA were larger in the males than in the females, but there was no sex difference in the diameter of the IA. The diameter of the SMA was larger than that of the IMA, and the diameter of the IA was smaller than that of the other arteries evaluated. An IA connecting the SMA and IMA trunks was found in 25.9% of the cases, while other connections between the branches of those trunks through an IA occurred less frequently. CONCLUSIONS: The intermesenteric artery is more frequently found than the literature refers and in most of cases directly connects the upper and lower arterial mesenteric circulations.


Assuntos
Angiografia , Artéria Mesentérica Inferior , Abdome , Adulto , Feminino , Humanos , Masculino , Artéria Mesentérica Inferior/anatomia & histologia , Artéria Mesentérica Inferior/diagnóstico por imagem , Artéria Mesentérica Superior/anatomia & histologia , Artéria Mesentérica Superior/diagnóstico por imagem , Tomografia Computadorizada por Raios X
4.
Anat Sci Int ; 96(1): 132-141, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32915395

RESUMO

The aim of this study is to determine vertebral levels of the coeliac trunk, the superior mesenteric artery, and the inferior mesenteric artery originated from the abdominal aorta and to calculate the distance measurements between these arteries and between these arteries and the aortic bifurcation by multidetector computed tomography angiography technique. It was determined that the nine different vertebral levels of the coeliac trunk, the nine different vertebral levels of the superior mesenteric artery, and the eleven different vertebral levels of the inferior mesenteric artery. The distance measurements between the coeliac trunk and the superior mesenteric artery, the inferior mesenteric artery, the aortic bifurcation were found significant between female and male. In this study, it was determined more different levels than the levels described in classical anatomy. The preoperative information of these morphological variations can contribute to the reduction of surgical time and perioperative vascular complications especially for anterior lumbar interbody fusion and defining the location of the primary lymphatic drainage site for gastrointestinal malignancies.


Assuntos
Artéria Celíaca/anatomia & histologia , Artéria Celíaca/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Artéria Mesentérica Inferior/anatomia & histologia , Artéria Mesentérica Inferior/diagnóstico por imagem , Artéria Mesentérica Superior/anatomia & histologia , Artéria Mesentérica Superior/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Adolescente , Adulto , Idoso , Aorta Abdominal/anatomia & histologia , Aorta Abdominal/diagnóstico por imagem , Feminino , Humanos , Vértebras Lombares/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Caracteres Sexuais , Adulto Jovem
5.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(12): 1144-1148, 2020 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-33353267

RESUMO

Colorectal surgeons have focused on the lateral structure of rectum for a long time and lateral ligament is the common term to depict this structure. A better understanding of lateral rectal structure could be beneficial to performing the total mesorectum excision (TME) procedure and protecting patients' urinary, sexual and defecation function. The main controversies focus on two aspects: (1) Does the lateral ligament exist? (2) What dose it contain? Does the middle rectal artery exist? Up to now, anatomic studies have failed to reach consensus on the lateral rectal structure. However, surgeons do find the lateral rectal ligament during surgery and it may be the pathway for lateral lymph node metastasis in rectal cancer. The lateral rectal structure contains the middle rectal artery, nerve branches, lymphatics and adipose fibrous tissue around them. We summarize our clinical experience and conclude that the middle rectal artery appears in lateral ligament constantly but some of them are too small to be easily observed. Therefore, regarding the perspective of membrane anatomy, embryology and surgery, this structure may be more appropriate to be called the "lateral mesorectum". We propose this new term based on the previous literature and our own experience for the readers' reference.


Assuntos
Ligamentos/anatomia & histologia , Artéria Mesentérica Inferior/anatomia & histologia , Mesentério/anatomia & histologia , Neoplasias Retais , Reto/anatomia & histologia , Humanos , Ligamentos/irrigação sanguínea , Ligamentos/cirurgia , Linfonodos/anatomia & histologia , Linfonodos/cirurgia , Artéria Mesentérica Inferior/cirurgia , Mesentério/irrigação sanguínea , Mesentério/cirurgia , Pelve/anatomia & histologia , Pelve/cirurgia , Neoplasias Retais/cirurgia , Reto/irrigação sanguínea , Reto/cirurgia
6.
Zhonghua Wai Ke Za Zhi ; 58(8): 600-603, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32727190

RESUMO

In order to increase the blood supply of anastomosis, surgeons choose to preserve the left colon artery (LCA) during the laparoscopic radical resection of rectal cancer. However, surgeons are always ailed by hemorrhage and incompletely dissection of No. 253 lymph nodes. One reason is the shortage of understanding the relationship between inferior mesenteric artery (IMA), LCA, and inferior mesenteric vein before surgery. Another reason is that surgeon always remove the lymph nodes around LCA, while don't normatively resect No. 253 lymph nodes, which affect the overall survival rate. Therefore, the "medial-to-lateral approach" for laparoscopic preservation with LCA radical resection in rectal cancer was suggested in this article. The CT technique could be used to analyze the IMA classification, which contribuated to the standard conservation of LCA. Laparoscopic radical resection of rectal cancer could be completed of high quality, through accurate definition and exactly dissection of the No. 235 lymph nodes.


Assuntos
Artéria Mesentérica Inferior/cirurgia , Neoplasias Retais/cirurgia , Reto/anatomia & histologia , Reto/cirurgia , Anastomose Cirúrgica/métodos , Humanos , Laparoscopia , Excisão de Linfonodo/métodos , Linfonodos/fisiologia , Linfonodos/cirurgia , Artéria Mesentérica Inferior/anatomia & histologia , Veias Mesentéricas/anatomia & histologia , Veias Mesentéricas/cirurgia , Reto/irrigação sanguínea
7.
Zhonghua Wai Ke Za Zhi ; 58(2): 119-124, 2020 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-32074811

RESUMO

Objective: To examine the characteristics of the digital subtraction angiography of inferior mesenteric artery (IMA) in elderly Chinese patients over 65 years old. Methods: Totally 64 cases who underwent angiography of IMA were selected from the Department of General Surgery, Xuanwu Hospital of Capital Medical University, including 42 males and 22 females, aging (70.9±5.1) years (range: 60 to 88 years). The origin, diameter and trunk length of IMA were analyzed. The distribution of IMA branching and the relationship between LCA and IMV at the level of IMA opening position were revealed. Also, the range of IMA perfusion, Riolan arch and IMA occlusion were observed. Results: All 64 patients underwent IMA angiography successfully. The diameter of IMA was (3.2±0.5) mm (range: 2.6 to 4.4 mm), and the trunk length was (3.8±1.0) cm (range: 1.1 to 7.0 mm). According to IMA classification standard, there were 26 patients with type Ⅰ (40.6%), 24 patients with type Ⅱ (37.5%), 12 patients with type Ⅲ (18.8%), 2 patients with type Ⅳ(3.1%). The horizontal distance between IMV and LCA was less than 0.5 cm in 58 cases (90.6%) and more than 0.5 cm in 6 cases (9.4%). IMA perfusion was interrupted at the splenic flexure in elderly patients in 14 cases (21.9%), including 11 cases terminated at splenic flexure and 3 cases terminated at descending colon. Riolan arch was found in only 4 of 64 patients (6.2%). Two patients (3.1%) had IMA or its branch occlusion, the arterial perfusion were compensated by Drummond arch without Riolan arch. Conclusions: The anatomy of IMA should be taken attention seriously in laparoscopic left-colorectal cancer radical resection. IMA shape, type, blood supply range and the relationship between LCA and IMV could be considered by the angiography or other examination, which can help to determine the ligation position of blood vessels, which could optimize the operation strategy.


Assuntos
Neoplasias Colorretais , Laparoscopia , Artéria Mesentérica Inferior , Idoso , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Ligadura , Masculino , Artéria Mesentérica Inferior/anatomia & histologia , Artéria Mesentérica Inferior/diagnóstico por imagem , Artéria Mesentérica Inferior/cirurgia
8.
Clin Anat ; 33(6): 850-859, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31883167

RESUMO

INTRODUCTION: The sigmoidea ima artery is defined as the lowest sigmoid artery, which forms the distal end of the marginal artery by linking with the superior rectal artery. It supplies the rectosigmoid junction, which is a critical area for ischemia. The aim of the present study was to delineate the area supplied by the inferior mesenteric artery with special consideration of the sigmoidea ima artery. MATERIALS AND METHODS: The inferior mesenteric artery was dissected from its origin to the bifurcation of the superior rectal artery in 30 cadavers (15 male, 15 female). Vessel length and distance to the promontory were measured for each branch. RESULTS: There were two manifestations of the sigmoidea ima artery, irrespective of the branching pattern of the inferior mesenteric artery. It originated below the promontory in 25 cases (83.3%) and above it in three (10%). It did not derive from the superior rectal artery in two cases (6.7%). In these 16.7%, the marginal artery was absent near the rectosigmoid junction. CONCLUSIONS: We suggest the terms "arteria sigmoidea ima pelvina" and "arteria sigmoidea ima abdominalis" for the two variants. The terms "arteria marginalis pelvina" and "arteria marginalis abdominalis" could be applied in clinical practice. An abdominal marginal artery could be considered a risk factor for colonic ischemia in colorectal resections and abdominal aortic aneurysm repair. Both variants should be considered when pre- and intra-operative perfusion measurements are interpreted.


Assuntos
Colo Sigmoide/irrigação sanguínea , Artéria Mesentérica Inferior/anatomia & histologia , Cadáver , Colite Isquêmica/etiologia , Feminino , Humanos , Masculino
10.
Surg Radiol Anat ; 41(3): 255-264, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30478643

RESUMO

PURPOSE: There is confusion regarding the names, the number, and the exact location of the colonic arterial arches which provide connections between the superior and inferior (IMA) mesenteric arteries at the level of the left colic angle. The aim of this review was to delineate the "true" colic arches arising in the meso of the left colic angle and to describe their surgical implications. METHODS: A systematic review of the literature was performed using the MEDLINE database. The search included only human studies between 1913 and 2018. All dissection, angiographic, arterial cast and corrosion studies were analyzed. RESULTS: The terms "Riolan arch", "marginal artery of Drummond", "meandering mesenteric artery" and "Villemin's arch" must no longer be used in the scientific literature. Three arterial arches were found at the level of the left colic angle, permitting the communication between the two arterial mesenteric systems: (1) the Marginal Artery (the most peripheral, found in 100% of cases); (2) the "V" termination of the ascending branch of the left colic artery (LCA), existing in more than 2/3 of cases; and (3) the inter-mesenteric trunk, found more centrally located and existing in less than 1/3 of cases. CONCLUSIONS: Three arterial arches exist at the level of the left colic angle: (1) the Marginal Artery, (2) the "V" termination of the ascending branch of the LCA, and (3) the inter-mesenteric trunk. The knowledge of this anatomy is essential for performing colorectal surgeries involving ligation of the IMA.


Assuntos
Colo/irrigação sanguínea , Artéria Mesentérica Inferior/anatomia & histologia , Artéria Mesentérica Superior/anatomia & histologia , Angiografia , Humanos
11.
World J Gastroenterol ; 24(32): 3671-3676, 2018 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-30166862

RESUMO

AIM: To investigate the vascular anatomy of inferior mesenteric artery (IMA) in laparoscopic radical resection with the preservation of left colic artery (LCA) for rectal cancer. METHODS: A total of 110 patients with rectal cancer who underwent laparoscopic surgical resection with preservation of the LCA were retrospectively reviewed. A 3D vascular reconstruction was performed before each surgical procedure to assess the branches of the IMA. During surgery, the relationship among the IMA, LCA, sigmoid artery (SA) and superior rectal artery (SRA) was evaluated, and the length from the origin of the IMA to the point of branching into the LCA or common trunk of LCA and SA was measured. The relationship between inferior mesenteric vein (IMV) and LCA was also evaluated. RESULTS: Three vascular types were identified in this study. In type A, LCA arose independently from IMA (46.4%, n = 51); in type B, LCA and SA branched from a common trunk of the IMA (23.6%, n = 26); and in type C, LCA, SA, and SRA branched at the same location (30.0%, n = 33). The difference in the length from the origin of IMA to LCA was not statistically significant among the three types. LCA was located under the IMV in 61 cases and above the IMV in 49 cases. CONCLUSION: The vascular anatomy of the IMA and IMV is essential for laparoscopic radical resection with preservation of the LCA for rectal cancer. To recognize different branches of the IMA is necessary for the resection of lymph nodes and dissection of vessels.


Assuntos
Endoscopia do Sistema Digestório/métodos , Laparoscopia/métodos , Artéria Mesentérica Inferior/anatomia & histologia , Neoplasias Retais/cirurgia , Reto/irrigação sanguínea , Idoso , Feminino , Humanos , Imageamento Tridimensional , Excisão de Linfonodo , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática , Masculino , Artéria Mesentérica Inferior/diagnóstico por imagem , Artéria Mesentérica Inferior/cirurgia , Veias Mesentéricas/anatomia & histologia , Pessoa de Meia-Idade , Tratamentos com Preservação do Órgão/métodos , Neoplasias Retais/patologia , Reto/diagnóstico por imagem , Reto/patologia , Reto/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
12.
Eur. j. anat ; 22(5): 415-418, sept. 2018. ilus
Artigo em Inglês | IBECS | ID: ibc-179812

RESUMO

Routine dissection of an 82-year-old cadaver demonstrated the inferior mesenteric artery arising from two roots: one from the coeliac trunk, and the other from the superior mesenteric artery. There was no discrete connection between the inferior mesenteric artery and the aorta. This variant artery gave off its characteristic branches, including left colic and sigmoidal branches.This can be explained as an abnormal persistence of the ventral longitudinal anastomotic channel. Furthermore, an understanding of the breadth of variations of mesenteric vasculature is essential to surgeons and proceduralists of the gastro-intestinal tract, and may have implications in cancer, retroperitoneal and endovascular surgery


No disponible


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Artéria Mesentérica Inferior/anatomia & histologia , Anastomose Arteriovenosa/anormalidades , Mesentério/irrigação sanguínea , Artéria Mesentérica Inferior/anormalidades , Cadáver
13.
Eur. j. anat ; 22(1): 67-73, ene. 2018. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-170483

RESUMO

Although the rectum is considered to be an organ rich in vascularity, the exact role of the middle rectal artery appears to be an area of much debate. Despite its principal supply from the superior rectal artery, there is a lack of information regarding the arterial supply to the fractionized proximal rectal regions. The approach to operative procedures in the case of recto-sigmoid carcinoma, intestinal embolization and haemorrhoidal disease are considered to be largely dependent on the intramural rectal anastomosis. Since the subsequent outcome of surgical intervention lies in the preservation of the respective rectal arteries, this study aimed to identify the proximal rectal arterial supply and the bilateral presence and/or variation of the middle rectal artery in ten fetal and ten adult cadaveric specimens (n=40). While the superior rectal artery presented as the principal arterial source to the proximal rectum, the respective regions of the proximal rectum were also found to be supplied by the median sacral and middle rectal arteries. The inconsistent morphological inconstant nature of the middle rectal artery confirmed that it does not represent the principal arterial source of the proximal rectum; however it was postulated that the middle rectal artery is regularly present in female individuals. As the regional arterial supply to the proximal rectum was investigated in accordance with appropriate anatomical landmarks, it may also be used to demarcate the specific regions of the proximal rectum. Furthermore, this may assist to preserve the rectal arterial supply during the Hartmann’s Procedure (AU)


No disponible


Assuntos
Humanos , Reto/anatomia & histologia , Artéria Mesentérica Inferior/anatomia & histologia , Artéria Ilíaca/anatomia & histologia , Artérias/anatomia & histologia , Colo Sigmoide/anatomia & histologia , Pelve/anatomia & histologia , Análise de Variância
14.
Surg Today ; 48(3): 359-363, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28993920

RESUMO

Lymph node dissection is a critical part of surgery for colorectal cancer. Japanese D3 and complete mesocolic excision are two unique principles for lymph node dissection in colorectal cancer. Laparoscopic surgery magnifies the targets and provides insight about the micro-anatomy through high-quality, high-definition imaging, which benefits the surgeon. Although laparoscopic colorectal resection is feasible, there is no universal procedure. We describe in detail the anatomy viewed during lymph node dissection around the inferior mesenteric artery. Visual recognition of two folds on both sides of Landzert's fossa is the critical first step, as recognizing these structures allows laparoscopic procedures to be performed safely. Our findings suggest that this procedure is feasible and effective for the surgical treatment of patients with left-sided colon or rectal cancer.


Assuntos
Neoplasias Colorretais/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Laparoscopia/métodos , Excisão de Linfonodo/métodos , Linfonodos/anatomia & histologia , Artéria Mesentérica Inferior/anatomia & histologia , Cirurgia Assistida por Computador/métodos , Estudos de Viabilidade , Humanos
15.
Okajimas Folia Anat Jpn ; 93(4): 139-145, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28637997

RESUMO

PURPOSE: To establish a method by which angiography of the inferior mesenteric artery (IMA) can be performed smoothly, we investigated the relative locations of the coeliac trunk (CT), superior mesenteric artery (SMA), IMA, and left renal artery (LtRA). METHODS: From a total of 60 cadavers, 32 cadavers with few arteriosclerotic lesions and little vascular tortuosity were selected for the study. The abdominal aorta (Ao) were removed and incised on both lateral side, along the vertical axis and transected into the ventral and dorsal sides. The intravascular lumen on the ventral side of the Ao was photographed using a digital camera, and the horizontal and vertical diameters of the sites of confluence of the CT, SMA, and IMA, were measured on the computer screen. We also calculated the distances between the branches, including the CT, SMA, IMA, LtRA, and the common iliac artery (CoI). RESULTS: Although the SMA-IMA distance did not correlate with the CT-SMA distance, the ratio of the SMA-IMA to CT-CoI distance was four times greater than the ratio of the CT-SMA to CT-CoI distance. CONCLUSIONS: The site of branching of the IMA can be inferred to some extent from the CT and SMA distance.


Assuntos
Angiografia/métodos , Artéria Mesentérica Inferior/anatomia & histologia , Artéria Mesentérica Inferior/diagnóstico por imagem , Idoso de 80 Anos ou mais , Artéria Celíaca/anatomia & histologia , Feminino , Humanos , Masculino , Artéria Mesentérica Superior/anatomia & histologia
16.
Int J Surg ; 41: 106-111, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28323157

RESUMO

OBJECTIVE: To demonstrate the clinical applicability of 3-dimensional CT angiography (3D-CTA) in evaluating the anatomic variations of inferior mesenteric artery (IMA) and left colic artery (LCA), to help make pre-operative strategies of rectal cancer surgery. METHODS: 188 patients with abdominal and pelvic contrast-enhanced CT scan were retrospectively enrolled and 3D-CTA was reconstructed. The origin and branching patterns of IMA, tracking patterns of LCA, intersectional patterns among IMA, LCA and inferior mesenteric vein (IMV) were examined, and their associations with clinical features were analyzed. RESULTS: The origin of IMA was located 42.1 ± 7.7 mm above iliac artery bifurcation, 64.4% within the area of the 3rd lumbar vertebra. 47.3% of LCA arose independently from IMA, 27.1% arose at the root of sigmoid artery (SA), 20.7% shared a common trunk with SA while 4.8% of LCA was absent. As for track of LCA before anastomosis with marginal artery, 53.2% went straight upward while medial to the inner border of left kidney (Type A), 27.1% traveled diagonally across left kidney (Type B) and14.9% went infero-laterally to the lower border of left kidney (Type C). Short IMA trunk was independently associated with type A LCA and lower site of IMA origin. At the horizontal level of IMA origin, 29% of the LCA went distant from IMV, while 71% (21% medial, 50% lateral) were mutually close, and the close type was independently associated with type A LCA. CONCLUSION: Preoperative understanding of the vascular variations and the mutual relationship among LCA, IMA and IMV could be obtained by 3D-CTA, which would further help surgeons to set detailed plans for laparoscopic rectal cancer surgery.


Assuntos
Variação Anatômica , Artérias/anatomia & histologia , Angiografia por Tomografia Computadorizada/métodos , Artéria Mesentérica Inferior/anatomia & histologia , Neoplasias Retais/diagnóstico por imagem , Artérias/diagnóstico por imagem , Colo Transverso/irrigação sanguínea , Colo Transverso/diagnóstico por imagem , Feminino , Humanos , Laparoscopia/métodos , Masculino , Artéria Mesentérica Inferior/diagnóstico por imagem , Artéria Mesentérica Inferior/cirurgia , Pessoa de Meia-Idade , Neoplasias Retais/cirurgia , Estudos Retrospectivos
17.
J. vasc. bras ; 16(1): f:52-l:55, Jan.-Mar. 2017. ilus
Artigo em Inglês | LILACS | ID: biblio-841409

RESUMO

Abstract In this article we present a rare variant in which the large intestine was vascularized by the inferior mesenteric artery. It was encountered during macro and microscopic dissection of the cadaver of a 63-year-old woman at a university department of human anatomy. In this case, the ascending, transverse, descending, and sigmoid colon and rectum were vascularized by the inferior mesenteric artery, whereas the small intestine, cecum and appendix were supplied by the superior mesenteric artery.


Resumo Neste artigo apresentamos uma variação rara em que o intestino grosso era vascularizado pela artéria mesentérica inferior. A variação foi descoberta durante a dissecção macro e microscópia de um cadáver do sexo feminino, 63 anos de idade, em um departamento universitário de anatomia humana. Neste caso, o cólon ascendente, transverso, descendente e sigmoide e também o reto eram vascularizados pela artéria mesentérica inferior, ao passo que o intestino delgado, ceco e apêndice eram vascularizados pela artéria mesentéria superior.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Intestino Grosso/anatomia & histologia , Artéria Mesentérica Inferior/anatomia & histologia , Anatomia , Colo Ascendente/anatomia & histologia , Dissecação/métodos , Intestino Delgado/anatomia & histologia , Artéria Mesentérica Superior/anatomia & histologia
18.
Surg Radiol Anat ; 39(7): 803-806, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27999945

RESUMO

The arterial system of the gastrointestinal tract has many variations. However, variation in the inferior mesenteric artery (IMA) is less common than for the other abdominal arteries. The case in the present cadaver subject showed a variation in the anatomy of the IMA that differed from those seen in previous studies, because it did not originate from the abdominal aorta and had no branches. A single artery arising from branches of the inferior pancreaticoduodenal and middle colic arteries supplied the hindgut. This variation generated blood vessels along the digestive tract during the later stages of development. The marginal artery of the colon in this case probably was more highly developed instead of the IMA. It is clinically important to know the range of variations, as these data are used in the diagnosis and treatment of abdominal diseases. This hitherto unknown variation might affect the health of patients, and we recommend radiographic examinations for diagnosis and treatment.


Assuntos
Artéria Mesentérica Inferior/anatomia & histologia , Idoso de 80 Anos ou mais , Variação Anatômica , Humanos , Masculino
19.
J Visc Surg ; 153(2): 113-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27009920

RESUMO

Two principal branches from the aorta provide the colonic blood supply: the superior and inferior mesenteric arteries. There are numerous anatomical variations, which the surgeon must fully understand before embarking on any colonic surgery. A good knowledge of these variations is particularly important when the patient has already undergone colectomy or presents with occlusive vascular disease. The aim of this review is to summarize the standard anatomy and the main variations of the colonic blood supply as they apply to colorectal surgery in this setting.


Assuntos
Aterosclerose/complicações , Colectomia/métodos , Artéria Mesentérica Inferior/cirurgia , Artéria Mesentérica Superior/cirurgia , Oclusão Vascular Mesentérica/complicações , Idoso , Colo/irrigação sanguínea , Colo/cirurgia , Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Humanos , Masculino , Artéria Mesentérica Inferior/anatomia & histologia , Artéria Mesentérica Superior/anatomia & histologia , Pessoa de Meia-Idade , Reoperação
20.
Transplant Proc ; 46(6): 1784-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25131037

RESUMO

UNLABELLED: In living donor liver transplantation, the right-sided graft presents thin and short vessels, bringing forward a more difficult anastomosis. In these cases, an interpositional arterial autograft can be used to favor the performance of the arterial anastomosis, making the procedure easier and avoiding surgical complications. OBJECTIVE: We compared the inferior mesenteric artery (IMA), the splenic artery (SA), the inferior epigastric artery (IEA), the descending branch of the lateral circumflex femoral artery (LCFA), and the proper hepatic artery (PHA) as options for interpositional autograft in living donor liver transplantation. METHOD: Segments of at least 3 cm of all 5 arteries were harvested from 16 fresh adult cadavers from both genders through standardized dissection. The analyzed measures were proximal and distal diameter and length. The proximal diameter of the RHA and the distal diameter of the SA, IMA, IEA and the LCFA were compared to the distal diameter of the RHA. The proximal and distal diameters of the SA, IEA and LCFA were compared to study caliber gain of each artery. RESULTS: All arteries except the IMA showed statistical significant difference in relation to the RHA in terms of diameter. Regarding caliber gain, the arteries demonstrated statistical significant difference. All the harvested arteries except PHA were 3 cm in length. CONCLUSION: The IMA demonstrated the best compatibility with the RHA in terms of diameter and showed sufficient length to be employed as interpositional graft. The PHA, the SA, the IEA and the LCFA presented statistically significant different diameters when compared to the RHA. Among these vessels, only the PHA did not show sufficient mean length.


Assuntos
Artérias/transplante , Autoenxertos/transplante , Transplante de Fígado/métodos , Doadores Vivos , Enxerto Vascular/métodos , Adulto , Artérias/anatomia & histologia , Autoenxertos/anatomia & histologia , Pesos e Medidas Corporais , Artérias Epigástricas/anatomia & histologia , Artérias Epigástricas/transplante , Feminino , Artéria Femoral/anatomia & histologia , Artéria Femoral/transplante , Artéria Hepática/anatomia & histologia , Artéria Hepática/transplante , Humanos , Masculino , Artéria Mesentérica Inferior/anatomia & histologia , Artéria Mesentérica Inferior/transplante , Artéria Esplênica/anatomia & histologia , Artéria Esplênica/transplante , Transplante Autólogo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...