Surgical anatomy of the accessory middle colic artery: a meta-analysis with implications for splenic flexure cancer surgery
| Autor: | R. Justin Davies, Justus J. Randolph, Isaac Cheruiyot, Jeremiah Munguti, Roberto Cirocchi, Brandon Michael Henry, B. M Ndungu |
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| Rok vydání: | 2020 |
| Předmět: |
Left colic artery
medicine.medical_specialty Accessory middle colic artery Splenic flexure 03 medical and health sciences 0302 clinical medicine Mesenteric Artery Superior medicine.artery Neoplasms Splenic flexure cancer medicine Humans Superior mesenteric artery Pancreas business.industry Gastroenterology Mesenteric Artery Inferior Surgery Middle colic artery medicine.anatomical_structure Lymphatic system 030220 oncology & carcinogenesis Meta-analysis Drainage 030211 gastroenterology & hepatology business Artery Colon Transverse |
| Zdroj: | Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and IrelandREFERENCES. 23(7) |
| ISSN: | 1463-1318 |
| Popis: | Background Surgical resection of splenic flexure cancers (SFC) is technically demanding due to the complex regional anatomy, characterized by the presence of embryological adhesions, close proximity to the pancreas and spleen, and a highly heterogenous arterial supply and lymphatic drainage. The accessory middle colic artery (AMCA) is increasingly being recognized as an important source of blood supply to the splenic flexure (SF). Therefore, this study aims to determine the prevalence and anatomical features of the AMCA. Methods A systematic search of the scientific literature was conducted on PubMed and Embase from inception through November 2020 to identify potentially eligible studies. Data were extracted and prevalence were pooled into a meta-analysis using MetaXL and Meta-Analyst softwares. Results A total of 16 studies (n=2,203 patients) were included. The pooled prevalence (PP) of AMCA was 25.4% (95% CI 18.1-33.4). Its prevalence was higher in patients without a left colic artery (LCA) (PP=83.2%; 95% CI 70.4-93.1). The commonest origin for the AMCA was the superior mesenteric artery (PP=87.9%; 95% CI 86.4-90.7). The AMCA shared a common trunk/ gave rise to pancreatic branches in 23.1% of cases (95% CI 95% CI 15.3-31.9). Conclusion The AMCA contributes to the vascularization of the splenic flexure in approximately 25% of individuals, and may be an important feeder artery to splenic flexure cancers (SFC), especially in the absence of the left colic artery (LCA). Preoperative identification of this artery is important to ensure optimal surgery for SFC and minimize complications. |
| Databáze: | OpenAIRE |
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