腹腔镜横结肠癌切除术,伴有源自脾动脉的结肠中动脉异常:病例报告。

IF 0.5 Q4 GASTROENTEROLOGY & HEPATOLOGY Case Reports in Gastroenterology Pub Date : 2024-03-04 eCollection Date: 2024-01-01 DOI:10.1159/000536672
Maeda Yoshiaki, Nozomi Minagawa, Takuya Kato, Naoki Okada, Takuto Suzuki, Chihiro Ishizuka, Akihisa Fukuda, Yoichi Mori
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引用次数: 0

摘要

导言:我们遇到了一个结肠癌病例,其结肠中动脉(MCA)起源于脾动脉(SA),这种异常非常罕见:我们遇到了一个结肠癌病例,其结肠中动脉(MCA)起源于脾动脉(SA),这种异常情况非常罕见:一名女性因横结肠癌转诊至我院。三维计算机断层扫描(3D-CT)血管造影显示,异常的 MCA 起源于脾动脉(SA),而不是典型的肠系膜上动脉(SMA)。患者接受了腹腔镜左半结肠切除术和 D3 淋巴结清扫术。从尾部视角解剖了SMA周围的淋巴结,证实没有典型的MCA。在胰腺下方发现了异常的起源于SA的MCA,对其进行了剪切和结扎;随后进行了肠系膜全切:结论:横结肠癌的 D3 淋巴结清扫术在技术上有一定难度,3D-CT 血管造影有助于术前发现血管异常,从而避免术中损伤。这是首例腹腔镜结肠切除术伴有SA源性MCA异常的病例报告。
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Laparoscopic Resection of Transverse Colon Cancer with an Anomaly of the Middle Colic Artery Originating from the Splenic Artery: A Case Report.

Introduction: We encountered a colon cancer case with a very rare anomaly of the middle colic artery (MCA) originating from the splenic artery (SA).

Case presentation: 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.

Conclusion: 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.

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来源期刊
Case Reports in Gastroenterology
Case Reports in Gastroenterology Medicine-Gastroenterology
CiteScore
1.10
自引率
0.00%
发文量
99
审稿时长
7 weeks
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