Patternd of the Inferior Mesenteric Artery and Those Branches and the Correlation of Other Marks

Takuya Sugimoto, title, Makio Mike, title, Nobuyasu Kano, title. Kameda Medical Center

[Introduction] Laparoscopic colorectal surgery has been standard procedure for colorectal cancer. Surgeons, however, often struggle because of the intraabdominal obesity, anomaly, disorientation or other reasons. The preoperative examinations have gotten more and more importance to accomplish operation safely in the era of laparoscopic surgery. Multidetector computed tomography (MDCT) and CT angiography (CTA) provide a lot of information. [Method and Procedures] This study from analyzing about 250 ceses of MDCT and CTA aimed two purposes, first, the pattern of the inferior mesenteric artery (IMA) and its branches, the left colic artery (LCA) and the first sigmoid artery (S-1), second, the correlation of the other marks, the umbilicus and the bifurcation of aorta. That information is necessary to consider the operative strategy and to make operation safer and easier. [Results] As defined that LCA is the first branch of IMA, there are three types. 1. LCA and S-1 branch independently from IMA(49.2%). 2. S-1 branches from LCA (32%). 3. LCA and S-1 co-branch from IMA (18.6%). The distance from the root of IMA to the root of LCA is not correlated with the body height or body mass index (BMI). And the distance from the root of IMA to the bifurcation of aorta or to the level of the iliac crest is not also correlated, either. [Conclusion] The frequency of the pattern of IMA and its branches is almost same as previously reported. It is hard to estimate the position of the root of IMA or LCA from the body height, BMI or other marks, such as the umbilicus or the bifurcation of aorta. It is important to use such images and prepare operation case by case preoperatively.

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