PDF(Pubmed)
Abstract：
BACKGROUND: Complete mesocolic excision (CME) and central vascular detachment are very important procedures in surgery for colorectal cancer. Preoperative and intraoperative assessments of the anatomy of major colorectal vessels are necessary to avoid massive bleeding, especially in endoscopic surgery. A case with a rare anomaly in which the middle colic artery (MCA) and ileocolic artery (ICA) had a common trunk is reported.
METHODS: The patient was a 73-year-old woman diagnosed with ascending colon cancer on colonoscopy. Preoperative abdominal contrast-enhanced computed tomography confirmed that the MCA and ICA had a common trunk. She underwent laparoscopic ileocecal resection for the ascending colon cancer with D3 lymph node dissection. Intraoperative indocyanine green fluorescence imaging was conducted. After confirming vessel bifurcation, the ICA was dissected at the distal end of the MCA bifurcation. The patient has been followed as an outpatient, with no signs of recurrence as of 2 years postoperatively.
CONCLUSIONS: A case of an ascending colon cancer with a unique vascular bifurcation pattern was presented. Preoperative and intraoperative evaluations of the major colorectal vessels are very important for preventing perioperative and postoperative complications.
METHODS: The patient was a 73-year-old woman diagnosed with ascending colon cancer on colonoscopy. Preoperative abdominal contrast-enhanced computed tomography confirmed that the MCA and ICA had a common trunk. She underwent laparoscopic ileocecal resection for the ascending colon cancer with D3 lymph node dissection. Intraoperative indocyanine green fluorescence imaging was conducted. After confirming vessel bifurcation, the ICA was dissected at the distal end of the MCA bifurcation. The patient has been followed as an outpatient, with no signs of recurrence as of 2 years postoperatively.
CONCLUSIONS: A case of an ascending colon cancer with a unique vascular bifurcation pattern was presented. Preoperative and intraoperative evaluations of the major colorectal vessels are very important for preventing perioperative and postoperative complications.
摘要：
背景：完整结肠系膜切除术（CME）和中央血管脱离是结直肠癌手术中非常重要的手术方法。术前和术中评估主要结直肠血管的解剖结构是必要的，以避免大量出血。尤其是在内窥镜手术中。据报道，罕见的异常病例中结肠动脉（MCA）和回结肠动脉（ICA）具有共同的干。
方法：患者是一名73岁女性，在结肠镜检查中被诊断为升结肠癌。术前腹部对比增强计算机断层扫描证实，MCA和ICA具有共同的躯干。她接受了腹腔镜回盲肠切除术治疗升结肠癌，并进行了D3淋巴结清扫。术中进行吲哚菁绿荧光成像。确认血管分叉后,在MCA分叉的远端解剖ICA。该患者已作为门诊病人被随访，术后2年无复发迹象。
结论：呈现一例具有独特血管分叉模式的升结肠癌。术前和术中评估结直肠主要血管对于预防围手术期及术后并发症非常重要。
方法：患者是一名73岁女性，在结肠镜检查中被诊断为升结肠癌。术前腹部对比增强计算机断层扫描证实，MCA和ICA具有共同的躯干。她接受了腹腔镜回盲肠切除术治疗升结肠癌，并进行了D3淋巴结清扫。术中进行吲哚菁绿荧光成像。确认血管分叉后,在MCA分叉的远端解剖ICA。该患者已作为门诊病人被随访，术后2年无复发迹象。
结论：呈现一例具有独特血管分叉模式的升结肠癌。术前和术中评估结直肠主要血管对于预防围手术期及术后并发症非常重要。
