title: Mesenteric fibromatosis of the transverse colon with the reconstruction of the superior mesenteric arteries: report of a case.
abstract: In general, with large mesenteric tumors it may be rather difficult to determine whether infiltration into adjacent large vessels occurred. We wish to stress the importance of preparation for microsurgery when a huge lesion appears close to a large artery in preoperative images, based on our experience of successful microscopical reconstruction of a superior mesenteric artery (SMA) and marked improvement of blocked vascular flow to the small intestine during the surgery. We have experienced a case of mesenteric fibromatosis (MF) invading the SMA and vein, contrary to preoperative expectation. The patient underwent extirpation of a MF, 21 cm in size, with reconstruction of the SMA by microsurgery. The sacrificed small intestine was only 80 cm of the distal ileum with the benefit of microscopic anastomosis between the SMA and a major jejunal artery. Preparations for microscopic surgery must be made with resection of large lesions, because involvement of mesenteric large vessels may be expected. It is possible for microsurgery to extend indications for surgical resection of huge mesenteric tumors.
authors.affiliation: Department of Surgery, Cancer Institute of the Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan. eijukai-seki@parkcity.ne.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Seki
authors.forename: Rintaro
authors.initials: R
authors.lastname: Koga
authors.forename: Akio
authors.initials: A
authors.lastname: Saiura
authors.forename: Ken
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kawabata
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kanda
authors.forename: Mutsuo
authors.initials: M
authors.lastname: Machinami
authors.forename: Masaru
authors.initials: M
authors.lastname: Nakagawa
mesh_terms: D000714:Anastomosis, Surgical; D044684:Colon, Transverse / Q000473:pathology / Q000601:surgery; D005260:Female; D005350:Fibroma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007421:Intestine, Small / Q000098:blood supply / Q000601:surgery; D017538:Mesenteric Artery, Superior / Q000601:surgery*; D008643:Mesentery / Q000098:blood supply / Q000601:surgery*; D008866:Microsurgery; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000601:surgery*; D014680:Veins / Q000601:surgery; D055815:Young Adult