Surgery today · 2026
Robot-assisted surgery for rectal cancer with persistent descending mesocolon: analysis of vascular anatomical features and short-term outcomes.
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Narumi Aya, Hanaoka Marie, Nakagawa Shunsaku, Nakagawa Mari, Yamauchi Shinichi, Kagawa Hiroyasu, Tokunaga Masanori, Kinugasa Yusuke
Аннотация
PURPOSE: Persistent descending mesocolon (PDM) is a rare congenital anomaly characterized by a medial shift of the descending colon and vascular variations that can complicate colorectal surgery. This study aimed to clarify the PDM-associated vascular anatomy and describe the short-term outcomes of robot-assisted surgery.
METHODS: We retrospectively analyzed 541 patients with primary rectal cancer who underwent robot-assisted surgery (2017-2024) and compared the short-term outcomes between the PDM and non-PDM groups. The vascular anatomy, including inferior mesenteric artery (IMA) branching patterns and marginal artery defects, was assessed in 501 patients using preoperative enhanced computed tomography.
RESULTS: PDM was identified in 22 patients (4.1%) in this study. The short-term outcomes were comparable between the groups. The PDM group had a significantly higher prevalence of radial IMA branching patterns and a higher frequency of marginal artery defects than the non-PDM group (9% vs. 2%).
CONCLUSION: PDM is associated with a higher prevalence of radial IMA branching patterns. Marginal artery defects were observed more frequently among patients with PDM; however, this finding requires cautious interpretation because of the small number of affected cases and potential verification bias. Appropriate identification and management of vascular variations may contribute to acceptable short-term outcomes of robot-assisted surgery in patients with PDM.
METHODS: We retrospectively analyzed 541 patients with primary rectal cancer who underwent robot-assisted surgery (2017-2024) and compared the short-term outcomes between the PDM and non-PDM groups. The vascular anatomy, including inferior mesenteric artery (IMA) branching patterns and marginal artery defects, was assessed in 501 patients using preoperative enhanced computed tomography.
RESULTS: PDM was identified in 22 patients (4.1%) in this study. The short-term outcomes were comparable between the groups. The PDM group had a significantly higher prevalence of radial IMA branching patterns and a higher frequency of marginal artery defects than the non-PDM group (9% vs. 2%).
CONCLUSION: PDM is associated with a higher prevalence of radial IMA branching patterns. Marginal artery defects were observed more frequently among patients with PDM; however, this finding requires cautious interpretation because of the small number of affected cases and potential verification bias. Appropriate identification and management of vascular variations may contribute to acceptable short-term outcomes of robot-assisted surgery in patients with PDM.