[Skeletization of the inferior mesenteric artery in colorectal surgery. Current considerations].
Anastomotic dehiscence after colon resection is the most frequent complication in colon surgery and the main cause of post-operative death. In the light of anatomical peculiarities of the blood supply to the rectum, it would appear that in atherosclerotic patients with impairment of hypogastric arteries (80% in authors' series out of 200 atherosclerotic subjects) inferior mesenteric artery ligature, determining vascularization of the rectal ampulla by the distal vessels alone, results in an insufficient supply in case of colo-rectal anastomosis. A series of 15 cases of cancer of the left and sigmoid colon, treated with left hemicolectomy, preservation and peeling of the inferior mesenteric artery, is reported. In the follow-up ranging from 6 months to 5 years, no anastomotic dehiscence was observed and only one case (7.5%) presented hepatic recurrence after two years. The other patients are all alive and disease free.
Napolitano
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AM
Istituto di Patologia Chirurgica, Università degli Studi di Chieti.
Napolitano
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L
Costantini
R
R
Ucchino
S
S
Innocenti
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P
D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000601:surgery; D003082:Colectomy / Q000379:methods; D015179:Colorectal Neoplasms / Q000601:surgery*; D006801:Humans; D017537:Mesenteric Artery, Inferior / Q000601:surgery*; D008875:Middle Aged; D012007:Rectum / Q000098:blood supply; D013529:Surgical Wound Dehiscence / Q000517:prevention & control
La scheletrizzazione dell'arteria mesenterica inferiore nella chirurgia colo-rettale. Considerazioni attuali.