Persistent Descending Mesocolon as An Intraoperative Risk Factor in Laparoscopic Surgery for Left-Sided Colon and...

Area of Science:

• Surgical anatomy
• Gastrointestinal surgery
• Minimally invasive surgery

Background:

• Persistent descending mesocolon (PDM) arises from incomplete fusion of the descending mesentery, causing anatomical variations.
• These anatomical abnormalities can impact surgical procedures and outcomes.

Purpose of the Study:

• To investigate the influence of PDM's anatomical features on laparoscopic surgical outcomes.
• To compare surgical results between patients with and without PDM undergoing left-sided colon and rectal cancer resection.

Main Methods:

• Retrospective comparison of 186 patients undergoing primary resection for left-sided colon and rectal cancer.
• Classification into PDM and non-PDM groups based on anatomical characteristics and operative findings.

Main Results:

• PDM patients experienced significantly longer operative times (337 vs. 239 min) and hospital stays (28 vs. 16 days).
• Intraoperative findings in PDM included mesenteric adhesion and abnormal fixation; LCA preservation was challenging.
• Ileus was more frequent in the PDM group, though overall postoperative complications did not differ significantly.

Conclusions:

• PDM is associated with increased operative time and postoperative hospital stay in laparoscopic surgery for left-sided colon and rectal cancer.
• Division of the left colonic artery (LCA) in PDM patients presents a significant intraoperative risk for marginal artery injury.