Ligation of the inferior mesenteric artery in the surgery of rectal cancer: anatomical considerations.
BACKGROUND
No agreement has been found in the literature concerning the safest point of ligation of the inferior mesenteric artery (ima) in order to avoid nerve damage during the surgery of rectal cancer.


METHODS
The distance between the origin of the ima and the left paraortic trunk was measured, as was the distance between the left paraortic trunk and the origin of the left colic artery (lca). The measurements were carried out on 20 cadavers and during 22 operations for rectal cancer.


RESULTS
The left paraortic trunk always runs posterior to the ima: its distance from the origin of the ima is on average 1.2 cm; the distance of the left paraortic trunk from the origin of the lca is on average 0.4 cm. The point at which the ima and the left paraortic trunk cross varies greatly, but it is never near the origin of the ima.


CONCLUSIONS
From an anatomical point of view the safest point of ligation of the ima is at its origin. At this point, the left paraortic trunk never runs; so there isn't any risk to damage the nerve involving it during the ligation of the artery.
Nano
Mario
M
Department of Clinical Pathophysiology, Section of General Surgery, University of Turin, Turin, Italy. mario.nano@unito.it
Dal Corso
Herbert
H
Ferronato
Marco
M
Solej
Mario
M
Hornung
Jean Pierre
JP
Dei Poli
Marcello
M
D002102:Cadaver; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008026:Ligation / Q000009:adverse effects / Q000379:methods; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D020196:Trauma, Nervous System / Q000209:etiology / Q000517:prevention & control*