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Techniques in Coloproctology
Published in: Techniques in Coloproctology 8/2019

01-08-2019 | Video Forum

Possible effects of height of ligation of the inferior mesenteric vein on venous return of the colorectal anastomosis: the venous trunk theory

Authors: A. García-Granero, G. Pellino, M. Frasson, V. Primo Romaguera, D. Fletcher-Sanfeliu, A. Blasco Serra, A. A. Valverde-Navarro, F. Martinez-Soriano, E. García-Granero

Published in: Techniques in Coloproctology | Issue 8/2019

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Excerpt

Poor arterial vascularization is an independent predictor of anastomotic failure after rectal resection with colorectal anastomosis [1]. However, there are little data available about the role of venous ischemia in anastomotic failure and how the risk of venous ischemia can be reduced. Ligation of the inferior mesenteric vein (IMV) makes it possible to gain length and to reduce the tension of the colorectal anastomosis [2]. Nevertheless, some authors state that this might be responsible for increased venous stasis, thereby increasing the risk of venous ischemia of the colorectal anastomosis [3]. Usually, little attention is paid to the correlation between the height of IMV ligation and the subsequent risk of developing venous ischemia. In this video, we show how to ligate the IMV to provide a colorectal anastomosis with an ideal venous return. …
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Literature
1.
Boyle NH, Manifold D, Jordan MH, Mason RC (2000) Intraoperative assessment of colonic perfusion using scanning laser Doppler flowmetry during colonic resection. J Am Coll Surg 191:504–510CrossRefPubMed
2.
Girard E, Trilling B, Rabattu PY, Sage PY, Taton N, Robert Y et al (2019) Level of inferior mesenteric artery ligation in low rectal cancer surgery: high tie preferred overlow tie. Tech Coloproctol 23:267–271CrossRefPubMed
3.
Bonnet S, Berger A, Hentati N, Abid B, Chevallier JM, Wind P et al (2012) High tie versus low tie vascular ligation of the inferior mesenteric artery in colorectal cancer surgery: impact on the gain in colon length and implications on the feasibility of anastomoses. Dis Colon Rectum 55:515–521CrossRefPubMed
4.
Graf O, Boland GW, Kaufman JA, Warshaw AL, Fernandez del Castillo C, Mueller PR (1997) Anatomic variants of mesenteric veins: depiction with helical CT venography. AJR Am J Roentgenol 168:1209–1213CrossRefPubMed
Metadata
Title
Possible effects of height of ligation of the inferior mesenteric vein on venous return of the colorectal anastomosis: the venous trunk theory
Authors
A. García-Granero
G. Pellino
M. Frasson
V. Primo Romaguera
D. Fletcher-Sanfeliu
A. Blasco Serra
A. A. Valverde-Navarro
F. Martinez-Soriano
E. García-Granero
Publication date
01-08-2019
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 8/2019
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-019-02038-2

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