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The Relation between Inferior Mesenteric Vein Ligation and Collateral Vessels to Splenic Flexure: Anatomical Landmarks, Technical Precautions and Clinical Significance
PURPOSE: Our aim to assess clinical significance of the relation between inferior mesenteric vein ligation and collateral blood supply (meandering mesenteric artery) to the splenic flexure with elaboration more in anatomical landmarks and technical tips. MATERIALS AND METHODS: We review the literatu...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Yonsei University College of Medicine
2013
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809879/ https://www.ncbi.nlm.nih.gov/pubmed/24142655 http://dx.doi.org/10.3349/ymj.2013.54.6.1484 |
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author | Al-Asari, Sami F. Lim, Daero Min, Byung Soh Kim, Nam Kyu |
author_facet | Al-Asari, Sami F. Lim, Daero Min, Byung Soh Kim, Nam Kyu |
author_sort | Al-Asari, Sami F. |
collection | PubMed |
description | PURPOSE: Our aim to assess clinical significance of the relation between inferior mesenteric vein ligation and collateral blood supply (meandering mesenteric artery) to the splenic flexure with elaboration more in anatomical landmarks and technical tips. MATERIALS AND METHODS: We review the literature regarding the significance of the collateral vessels around inferior mesenteric vein (IMV) root and provide our prospective operative findings, anatomical landmarks and technical tips. We analyzed the incidence and pattern of anatomic variation of collateral vessels around the IMV. RESULTS: A total of 30 consecutive patients have been prospectively observed in a period between June 25-2012 and September 7-2012. Nineteen males and eleven females with mean age of 63 years. Major colorectal procedures were included. There were three anatomical types proposed, based on the relation between IMV and the collateral vessel. Type A and B in which either the collateral vessel crosses or runs close to the IMV with incidence of 43.3% and 13.3%, respectively, whereas type C is present in 43.3%. There was no definitive relation between the artery and vein. No intra or postoperative ischemic events were reported. CONCLUSION: During IMV ligation, inadvertent ligation of Arc of Riolan or meandering mesenteric artery around the IMV root "in type A&B" might result in compromised blood supply to the left colon, congestion, ischemia and different level of colitis or anastomotic dehiscence. Therefore, careful dissection and skeletonization at the IMV root "before ligation if necessary" is mandatory to preserve the collateral vessel for the watershed area and to avoid further injury. |
format | Online Article Text |
id | pubmed-3809879 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Yonsei University College of Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-38098792013-11-01 The Relation between Inferior Mesenteric Vein Ligation and Collateral Vessels to Splenic Flexure: Anatomical Landmarks, Technical Precautions and Clinical Significance Al-Asari, Sami F. Lim, Daero Min, Byung Soh Kim, Nam Kyu Yonsei Med J Original Article PURPOSE: Our aim to assess clinical significance of the relation between inferior mesenteric vein ligation and collateral blood supply (meandering mesenteric artery) to the splenic flexure with elaboration more in anatomical landmarks and technical tips. MATERIALS AND METHODS: We review the literature regarding the significance of the collateral vessels around inferior mesenteric vein (IMV) root and provide our prospective operative findings, anatomical landmarks and technical tips. We analyzed the incidence and pattern of anatomic variation of collateral vessels around the IMV. RESULTS: A total of 30 consecutive patients have been prospectively observed in a period between June 25-2012 and September 7-2012. Nineteen males and eleven females with mean age of 63 years. Major colorectal procedures were included. There were three anatomical types proposed, based on the relation between IMV and the collateral vessel. Type A and B in which either the collateral vessel crosses or runs close to the IMV with incidence of 43.3% and 13.3%, respectively, whereas type C is present in 43.3%. There was no definitive relation between the artery and vein. No intra or postoperative ischemic events were reported. CONCLUSION: During IMV ligation, inadvertent ligation of Arc of Riolan or meandering mesenteric artery around the IMV root "in type A&B" might result in compromised blood supply to the left colon, congestion, ischemia and different level of colitis or anastomotic dehiscence. Therefore, careful dissection and skeletonization at the IMV root "before ligation if necessary" is mandatory to preserve the collateral vessel for the watershed area and to avoid further injury. Yonsei University College of Medicine 2013-11-01 2013-10-01 /pmc/articles/PMC3809879/ /pubmed/24142655 http://dx.doi.org/10.3349/ymj.2013.54.6.1484 Text en © Copyright: Yonsei University College of Medicine 2013 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Al-Asari, Sami F. Lim, Daero Min, Byung Soh Kim, Nam Kyu The Relation between Inferior Mesenteric Vein Ligation and Collateral Vessels to Splenic Flexure: Anatomical Landmarks, Technical Precautions and Clinical Significance |
title | The Relation between Inferior Mesenteric Vein Ligation and Collateral Vessels to Splenic Flexure: Anatomical Landmarks, Technical Precautions and Clinical Significance |
title_full | The Relation between Inferior Mesenteric Vein Ligation and Collateral Vessels to Splenic Flexure: Anatomical Landmarks, Technical Precautions and Clinical Significance |
title_fullStr | The Relation between Inferior Mesenteric Vein Ligation and Collateral Vessels to Splenic Flexure: Anatomical Landmarks, Technical Precautions and Clinical Significance |
title_full_unstemmed | The Relation between Inferior Mesenteric Vein Ligation and Collateral Vessels to Splenic Flexure: Anatomical Landmarks, Technical Precautions and Clinical Significance |
title_short | The Relation between Inferior Mesenteric Vein Ligation and Collateral Vessels to Splenic Flexure: Anatomical Landmarks, Technical Precautions and Clinical Significance |
title_sort | relation between inferior mesenteric vein ligation and collateral vessels to splenic flexure: anatomical landmarks, technical precautions and clinical significance |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809879/ https://www.ncbi.nlm.nih.gov/pubmed/24142655 http://dx.doi.org/10.3349/ymj.2013.54.6.1484 |
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