Preoperative evaluation of mesenteric vascular anatomy using 256 multi-slice computed tomography before laparoscopic surgery

/Sun Hongliang

(孫宏亮，Dept Radiol，China-Japan Friendship Hosp，Beijing 100029)…∥Chin JGastrointest Surg.-2011，14(8).-855～858

ObjectiveTo evaluate mesenteric vascular anatomy using 256 multi-slice computed tomography(MSCT)before laparoscopic colorectal surgery.MethodsEleven patients with colorectal cancer underwent 256 MSCT from February 2010 to December 2010.The evaluation items were visualization of mesenteric artery and vein by 3-dimensional CT angiography，which was compared with findings on laparoscopic surgery.ResultsThree-dimensional CT angiography correctly demonstrated variations of the mesenteric artery and vein and were consistent with laparoscopic findings.Of the 3 patients undergoing right hemicolectomy，ileocolic artery(ICA)ran ventrally to the superior mesenteric vein(SMV)in 1 patient，whereas ICA ran dorsally to the SMV in 2 patients;the right colic artery(RCA)branched directly from superior mesenteric artery(SMA)in 2 patients;RCA was absent and the left branch of middle colic artery(MCA)fed the tumor in 1 patient.In the patients who had transverse colon resection，MCA branched from SMA.In 2 of 3 patients who underwent sigmoidectomy，sigmoid artery(SA)branched from left colic artery(LCA);in 1 of 3 patients of sigmoid resection，SA branched from inferior mesenteric artery(IMA).In 4 patients with rectal cancer，the superior rectal artery(SRA)fed the tumor.ConclusionThe 256 MSCT is effective for evaluating mesenteric vascular anatomy variation before laparoscopic surgery for colorectal cancer.10 refs，5 figs.