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Surgical and Radiologic Anatomy

Published in:

01-05-2016 | Original Article

Technical difficulties of left colic artery preservation during left colectomy for colon cancer

Authors: A. Patroni, S. Bonnet, C. Bourillon, M. Bruzzi, F. Zinzindohoué, J. M. Chevallier, R. Douard, A. Berger

Published in: Surgical and Radiologic Anatomy | Issue 4/2016

Abstract

Purpose

Low-tie ligation in colorectal cancer surgery is associated with technical difficulties in left colic artery preservation. We aimed to evaluate and classify the anatomical and technical difficulties of left colic artery (LCA) preservation at its origin and along its route at the inferior border of the pancreas.

Methods

A vascular reconstruction computed tomography prospective series of 113 patients was analyzed. The inferior mesenteric artery (IMA) branching pattern according to Latarjet’s classification (Type I, separate LCA origin, Type II, fan-shaped branching pattern) and the distances between the IMA and the LCA origins and between the LCA and the Inferior mesenteric vein (IMV) at the inferior border of the pancreas were measured.

Results

The IMA branching pattern was Type I in 80 (71 %) patients and Type II in 33 (29 %) patients. The IMA-LCA distance was 39.8 ± 12.2 mm. The LCA-IMV distance at the inferior border of the pancreas was 20.5 ± 21.7 mm. When classified based on this distance, 75 (66 %) patients were classified into the Near subgroup (<20 mm) (7.7 ± 4.1 mm) and 38 (34 %) into the Far subgroup (≥20 mm) (45.6 ± 20.4 mm, p < 0.001). A Type I subgroup F accounted for 27 % of the patients.

Conclusions

Left colic artery preservation is highly feasible at its origin in more than two-thirds of cases due to the separate origin. The addition of a high IMV ligation increases the risk of damage to the LCA at the inferior border of the pancreas because the distance to the IMV is less than 20 mm in two-thirds of cases.

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Title: Technical difficulties of left colic artery preservation during left colectomy for colon cancer
Authors: A. Patroni
S. Bonnet
C. Bourillon
M. Bruzzi
F. Zinzindohoué
J. M. Chevallier
R. Douard
A. Berger
Publication date: 01-05-2016
Publisher: Springer Paris
Published in: Surgical and Radiologic Anatomy / Issue 4/2016
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-015-1583-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Technical difficulties of left colic artery preservation during left colectomy for colon cancer

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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