Abstract：
OBJECTIVE: By selectively perfusing the first three jejunal arteries (JA), we aim to assess the individual perfusion length of small bowel (SB) and its impact on nodal resection in stage III-up small-intestinal neuroendocrine tumors (SI-NET).
METHODS: Our anatomical research protocol implies a midline laparotomy and three measures of the SB length. We then perform a classical anterior approach of the superior mesenteric vessels. We carry on with the complete dissection and checking of the superior mesenteric artery (SMA) in order to identify the first three JA. Then we selectively perfuse each artery with colored latex solutions and measure the length of small bowel perfused respectively.
RESULTS: We conducted our protocol on six cadaveric subjects. Mean(SD) SB length was 413(5.7), 535(13.2), 485(15), 353(25.1), 730(17.3) and 525(16° cm respectively from subject one to six. Most JA originated from the left side of the SMA. The first JA originated from its posterior wall in two subjects. Mean(SD) distance of origin of the first three JA was 4.6(1.3)cm, 6(1.1)cm and 7.1(0.9)cm respectively. Mean(SD) diameter of SMA was 10.8(3.3)mm. Mean diameter of the three first JA was 4(1.4)mm, 4(1.5)mm and 5(1.2)mm respectively. Mean(SD) SB length perfused by first and second JA was 224(14.9)cm, 175(8.6)cm, 238.3(7.6)cm, 84.3(5.1)cm, 233.3(5.8)cm and 218.3(10.4)cm respectively from subject one to six.
CONCLUSIONS: We observed a trend suggesting that the first and second JA may sustain a SB length beyond the viable 1.5 m limit, implying the feasibility of stage III-up SI-NET resection with just two JA.
METHODS: Our anatomical research protocol implies a midline laparotomy and three measures of the SB length. We then perform a classical anterior approach of the superior mesenteric vessels. We carry on with the complete dissection and checking of the superior mesenteric artery (SMA) in order to identify the first three JA. Then we selectively perfuse each artery with colored latex solutions and measure the length of small bowel perfused respectively.
RESULTS: We conducted our protocol on six cadaveric subjects. Mean(SD) SB length was 413(5.7), 535(13.2), 485(15), 353(25.1), 730(17.3) and 525(16° cm respectively from subject one to six. Most JA originated from the left side of the SMA. The first JA originated from its posterior wall in two subjects. Mean(SD) distance of origin of the first three JA was 4.6(1.3)cm, 6(1.1)cm and 7.1(0.9)cm respectively. Mean(SD) diameter of SMA was 10.8(3.3)mm. Mean diameter of the three first JA was 4(1.4)mm, 4(1.5)mm and 5(1.2)mm respectively. Mean(SD) SB length perfused by first and second JA was 224(14.9)cm, 175(8.6)cm, 238.3(7.6)cm, 84.3(5.1)cm, 233.3(5.8)cm and 218.3(10.4)cm respectively from subject one to six.
CONCLUSIONS: We observed a trend suggesting that the first and second JA may sustain a SB length beyond the viable 1.5 m limit, implying the feasibility of stage III-up SI-NET resection with just two JA.
摘要：
目的：通过选择性地灌注前三个空肠动脉（JA），我们旨在评估小肠灌注长度(SB)及其对III期小肠神经内分泌肿瘤(SI-NET)淋巴结切除的影响.
方法：我们的解剖学研究方案意味着中线剖腹手术和三个SB长度测量。然后，我们对肠系膜上血管进行经典的前入路。我们进行完全解剖和检查肠系膜上动脉（SMA），以确定前三个JA。然后我们用彩色乳胶溶液选择性地灌注每条动脉，并分别测量灌注的小肠长度。
结果：我们对六名尸体受试者进行了研究。平均（SD）SB长度为413（5.7），535(13.2),485(15),353（25.1），730（17.3）和525（16°cm分别从受试者一到六。大多数JA起源于SMA的左侧。第一个JA起源于两个受试者的后壁。前三个JA的平均（SD）原点距离为4.6（1.3）cm，6（1.1）cm和7.1（0.9）cm。SMA的平均(SD)直径为10.8(3.3)mm。三个第一JA的平均直径为4（1.4）mm，4（1.5）毫米和5（1.2）毫米。第一次和第二次JA灌注的平均（SD）SB长度为224（14.9）cm，175(8.6)cm,238.3(7.6)cm,84.3(5.1)cm,受试者一至六分别为233.3(5.8)cm和218.3(10.4)cm。
结论：我们观察到一种趋势，表明第一和第二JA可能维持SB长度超过可行的1.5m限制，暗示仅使用两个JA进行III期SI-NET切除的可行性。
方法：我们的解剖学研究方案意味着中线剖腹手术和三个SB长度测量。然后，我们对肠系膜上血管进行经典的前入路。我们进行完全解剖和检查肠系膜上动脉（SMA），以确定前三个JA。然后我们用彩色乳胶溶液选择性地灌注每条动脉，并分别测量灌注的小肠长度。
结果：我们对六名尸体受试者进行了研究。平均（SD）SB长度为413（5.7），535(13.2),485(15),353（25.1），730（17.3）和525（16°cm分别从受试者一到六。大多数JA起源于SMA的左侧。第一个JA起源于两个受试者的后壁。前三个JA的平均（SD）原点距离为4.6（1.3）cm，6（1.1）cm和7.1（0.9）cm。SMA的平均(SD)直径为10.8(3.3)mm。三个第一JA的平均直径为4（1.4）mm，4（1.5）毫米和5（1.2）毫米。第一次和第二次JA灌注的平均（SD）SB长度为224（14.9）cm，175(8.6)cm,238.3(7.6)cm,84.3(5.1)cm,受试者一至六分别为233.3(5.8)cm和218.3(10.4)cm。
结论：我们观察到一种趋势，表明第一和第二JA可能维持SB长度超过可行的1.5m限制，暗示仅使用两个JA进行III期SI-NET切除的可行性。
