200例肠系膜上血管及其属支的术中实时解剖研究:单中心前瞻性队列研究  

Real-time intraoperative anatomy study of 200 cases of superior mesenteric vessels and its tributaries:A single-center prospective cohort study

作　　者：李珂璇 厉弘博 陆君阳 徐徕 张冠南 孙振 肖毅 LI Kexuan;LI Hongbo;LU Junyang;XU Lai;ZHANG Guannan;SUN Zhen;XIAO Yi(Division of Colorectal Surgery,Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,P.R.China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院基本外科结直肠专业组,北京100730

出　　处：《中国普外基础与临床杂志》2025年第1期83-87,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：中国医学科学院临床与转化医学研究专项项目(项目编号:2022-I2M-C&T-A-001)。

摘　　要：目的探索肠系膜上血管属支的出现率及其毗邻关系。方法本研究为前瞻性研究,收集2016年7月至2022年9月期间于北京协和医院基本外科行腹腔镜全结肠系膜右半结肠切除的恶性肿瘤患者。术者在术中对血管解剖实时观察并由住院医师实时登记记录。计数资料以频数及百分率(%)描述,不符合正态分布的计量资料以中位数(上下四分位数)描述。结果本研究共纳入患者200例,其中男114例、女86例,年龄63.5(53.5,72.0)岁。回结肠动脉及静脉的出现率分别为98.0%(196/200)及98.5%(197/200),195例回结肠动脉和静脉同时出现时动脉和静脉根部重叠发生率为86.2%(168/195)。右结肠动脉和静脉的出现率分别为39.5%(79/200)和18.5%(37/200)。结肠中动脉及静脉的出现率分别为96.5%(193/200)及90.5%(181/200),174例结肠中动脉和静脉同时出现时动脉和静脉根部重叠发生率为67.8%(118/174),结肠中动脉主干长度为2.2(1.6,3.2)cm。Henle干的出现率为92.5%(185/200),其主干长度为1.00(0.50,1.40)cm,下缘距离胰头与十二指肠水平交界处2.80(2.20,3.30)cm。结论从本组数据分析结果提示,回结肠动静脉出现率较高且恒定,其动脉和静脉根部重叠发生率较高,可将它作为腹腔镜全结肠系膜右半结肠切除术中尾侧中央入路的最佳解剖标志点。Objective To explore the prevalence and adjacency of the tributaries of superior mesenteric vessel.Methods This study is a prospective study.The patients with right-sided colonic malignant tumor who underwent laparoscopic complete mesocolon excision at the Division of Colorectal Surgery of Peking Union Medical College Hospital from July 2016 to September 2022 were collected.The real-time observation and evaluation of vascular anatomy was performed by the operator and recorded by a resident.The continuous variables without a normal distribution were summarized as median(P25,P75).The categorical variables were presented as number(%).Results A total of 200 patients were enrolled,including 114 males and 86 females,with an age of 63.5(53.5,72.0)years.The prevalence of ileocolic artery and vein was 98.0%(196/200)and 98.5%(197/200),respectively.There were 168(86.2%)cases of the ileocolic vein accompanied the course of the ileocolic artery at the origin in 195 patients with simultaneous presence of ileocolic artery and vein.The right colic artery and vein was present in 39.5%(79/200)and 18.5%(37/200)patients,respectively.The prevalence of the middle colic artery and vein was 96.5%(193/200)and 90.5%(181/200),respectively.And the prevalence of the middle colic vein accompanied the path of the middle colic artery at the root was 67.8%(118/174)in the 174 patients with simultaneous presence of middle colic artery and vein.The trunk length of the middle colic artery was 2.2(1.6,3.2)cm.The Henle trunk was present in 185(92.5%)cases,with a trunk length of 1.00(0.50,1.40)cm,and its lower edge was 2.80(2.20,3.30)cm from the junction of the pancreatic head and the horizontal part of the duodenum.Conclusions The results from the data analysis of this study suggest that the ileocolic artery and vein are present most constantly with a high incidence of the ileocolic vein accompanied the course of the ileocolic artery at the origin of superior mesenteric vessels.Therefore ileocolic artery and vein are expected to serve as an optimal an

关 键 词：肠系膜上动脉 肠系膜上静脉 解剖学 全结肠系膜切除术 腹腔镜右半结肠切除术 

分 类 号：R657.2[医药卫生—外科学]