LEFT HEMICOLECTOMY IN PATIENTS WITH COLORECTAL CANCER: SURGICAL VIEW ON INFERIOR MESENTERIC ARTERY ANATOMY VARIABILITY.

BACKGROUND AND

OBJECTIVES

Vascular structures may be damaged during laparoscopic surgery for colorectal cancer. One of the major reasons is the variant anatomy of the inferior mesenteric artery. It could lead to intraoperative massive bleeding and also postoperative intestinal ischemia. Thus, preoperative study of the inferior mesenteric artery variant anatomy is very important.

AIM: Our aim is to develop a clinical - based and useful classification of inferior mesenteric artery variability for healthcare practitioners.

MATERIALS AND

METHODS

From December 2019 to March 2023, 214 abdominal computed tomograms (CT) with contrast were analyzed. We studied the inferior mesenteric artery variant anatomy.

RESULTS

The 15 inferior mesenteric artery anatomical types were identified in previous studies. But due to the complexity of using this in practice - new classification of inferior mesenteric artery anatomy and its branches was developed: type I - several colonic branches by separate trunks (54.2%); type II - all colonic branches from one point in the form of a "crow's foot" (25.2%); type III - a single trunk which is divided into colonic branches throughout its length (20.6%).

CONCLUSIONS

The new inferior mesenteric artery classification is developed and been induced in practice. By using this classification and CT angiography with 3D reconstruction surgeons could perform operations on colorectal region with minimal risk of complications.