PMID- 31768467
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2432-3853 (Electronic)
IS  - 2432-3853 (Linking)
VI  - 3
IP  - 4
DP  - 2019
TI  - Microanatomy of inferior mesenteric artery sheath in colorectal cancer surgery.
PG  - 167-174
LID - 10.23922/jarc.2019-016 [doi]
AB  - OBJECTIVES: Left colic artery preserving lymph node dissection around the 
      inferior mesenteric artery (IMA) is a standard procedure for rectal cancer 
      surgery. Although the IMA sheath is a well-known structure, to our knowledge, 
      there are no reports describing its microanatomy from an oncological point of 
      view; therefore, there is no consensus on how to handle the sheath for accurate 
      lymph node dissection around IMA. We aimed to investigate the components of the 
      IMA sheath pathologically, focusing particularly on the presence of lymph nodes 
      (LNs) and lymphatic ducts (LDs). METHODS: We evaluated rectal and sigmoid cancer 
      specimens resected with high-tie technique in our institute in April 2017-April 
      2018. The specimens were collected consecutively, without any selection. In the 
      resected specimens, the entire anatomical structure of IMA was investigated. We 
      defined the IMA sheath as the tissues located between the surface of the IMA 
      adventitia and collagenous layers connecting the outermost nerve fibers. The 
      microanatomy around the IMA was examined using H&E staining, and LDs were 
      identified using D2-40 immunohistochemistry. RESULTS: Twenty patients were 
      enrolled. No LNs were observed within the sheath in any of the cases. However, 
      there were a significant number of LDs (11.08 +/- 3.35) within the sheath. 
      CONCLUSIONS: Our anatomical definition of IMA sheath was feasible and objectively 
      possible. These microanatomical results partially support the surgical concept of 
      left colic artery preserving lymph node dissection around the IMA. It may be 
      difficult to remove all lymphatic ducts without removing the IMA itself.
CI  - Copyright (c) 2019 by The Japan Society of Coloproctology.
FAU - Sakamoto, Wataru
AU  - Sakamoto W
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
FAU - Yamada, Leo
AU  - Yamada L
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
FAU - Suzuki, Osamu
AU  - Suzuki O
AD  - Department of Diagnostic Pathology, School of Medicine, Fukushima Medical 
      University, Fukushima, Japan.
FAU - Kikuchi, Tomohiro
AU  - Kikuchi T
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
FAU - Okayama, Hirokazu
AU  - Okayama H
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
FAU - Endo, Hisahito
AU  - Endo H
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
FAU - Fujita, Shotaro
AU  - Fujita S
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
FAU - Saito, Motonobu
AU  - Saito M
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
FAU - Momma, Tomoyuki
AU  - Momma T
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
FAU - Saze, Zenichiro
AU  - Saze Z
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
FAU - Ohki, Shinji
AU  - Ohki S
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
FAU - Kono, Koji
AU  - Kono K
AD  - Department of Gastrointestinal Tract Surgery, School of Medicine, Fukushima 
      Medical University, Fukushima, Japan.
LA  - eng
PT  - Journal Article
DEP - 20191030
PL  - Japan
TA  - J Anus Rectum Colon
JT  - Journal of the anus, rectum and colon
JID - 101718055
PMC - PMC6845289
OTO - NOTNLM
OT  - colorectal cancer
OT  - inferior mesenteric artery
OT  - left colic artery
OT  - low-tie with lymph node dissection
OT  - lymph node dissection
COIS- Conflicts of Interest There are no conflicts of interest.
EDAT- 2019/11/27 06:00
MHDA- 2019/11/27 06:01
PMCR- 2019/10/30
CRDT- 2019/11/27 06:00
PHST- 2019/06/20 00:00 [received]
PHST- 2019/08/30 00:00 [accepted]
PHST- 2019/11/27 06:00 [entrez]
PHST- 2019/11/27 06:00 [pubmed]
PHST- 2019/11/27 06:01 [medline]
PHST- 2019/10/30 00:00 [pmc-release]
AID - 10.23922/jarc.2019-016 [doi]
PST - epublish
SO  - J Anus Rectum Colon. 2019 Oct 30;3(4):167-174. doi: 10.23922/jarc.2019-016. 
      eCollection 2019.