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《Chinese Journal of Anatomy》 2006-05
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Inferior mesenteric vessels related clinical anatomy in laparoscopy

LI Guo-Xin, DING Zi-Hai, ZHANG Ce, YU Jiang, HUANG Xiang-Cheng, ZHONG Shi-Zhen (Department of General Surgery, Nan fang Hospital, Nan fang Medical University, Guangzhou 510515, China)  
Objective: To explore the anatomical characteristics of the inferior mesenteric vessels in laparoscopic radical resection of rectal cancer. Methods: Live anatomical observations were carried out on 105 rectal cancer patients undergoing laparoscopic radical resection in Nanfang Hospital from Nov, 2002 to June, 2005. Results: The origin of inferior mesenteric artery (IMA) was successfully localized by dissection in Toldt's space cephalad to the aortic branch after the middle Toldt's line incision. It was unveiled in the operation window posterior to mesosigmoid formed by pulling the mesentery and keeping vertical angle to the aorta. The inferior mesenteric vein (IMV) was exposed and dissected clearly posterior to the mesosigmoid. Combined with anterior dissection, high level division of IMV was achieved. Conclusion: The Toldt's space is the right surgical plane to localize the IMA; the aortic bifurcation is the location landmark. Vertical traction, artery skeletonization and division at origin are the foundation of anatomy. Dissections both posterior and anterior to the mesosigmoid are effective methods to identify and divide the IMV at high level.
【Fund】: 广东省科技计划项目(2004B35001010)
【CateGory Index】: R322
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