UNASSIGNED: A woman was referred to our hospital for transverse colon cancer. Three-dimensional computed tomography (3D-CT) angiography showed an anomalous MCA originating from the SA rather than from the superior mesenteric artery (SMA) as is typical. Laparoscopic left hemicolectomy with D3 lymph node dissection was performed. The lymph nodes around the SMA were dissected from the caudal view, confirming the absence of a typical MCA. An anomalous SA-originating MCA was identified just below the pancreas, where it was clipped and ligated; subsequently, total mesenteric excision was achieved.
UNASSIGNED: As D3 lymph node dissection for transverse colon cancer is technically difficult, 3D-CT angiography is useful for identifying vascular anomalies preoperatively, thereby avoiding intraoperative injury. This is the first case report of laparoscopic colectomy associated with a SA-originating MCA anomaly.
■一名妇女因横结肠癌被转诊到我们医院。三维计算机断层扫描(3D-CT)血管造影显示异常的MCA起源于SA,而不是典型的肠系膜上动脉(SMA)。行腹腔镜左半结肠切除术并D3淋巴结清扫术。从尾部视图解剖SMA周围的淋巴结,确认没有典型的MCA。胰腺下方发现了一个异常的SA起源MCA,在那里被剪接和结扎;随后,实现了肠系膜全切除。
■由于横结肠癌的D3淋巴结清扫在技术上很困难,3D-CT血管造影可用于术前识别血管异常,从而避免术中损伤。这是与SA起源的MCA异常相关的腹腔镜结肠切除术的首例报告。