[Six Case Reports of Colorectal Surgery with Persistent Descending Mesocolon]

Area of Science:

• Surgical Oncology
• Embryological Development
• Gastrointestinal Surgery

Background:

• Persistent descending mesocolon (PDM) is a congenital anomaly resulting from incomplete fusion of the left colon with the parietal peritoneum during embryogenesis.
• PDM cases often feature extensive adhesions and anomalous vascular branching, increasing surgical complexity and risks.
• These anatomical variations necessitate meticulous surgical technique to prevent iatrogenic intestinal injury and ischemia.

Purpose of the Study:

• To report surgical experiences with colorectal cancer in patients presenting with Persistent Descending Mesocolon.
• To highlight the potential complications associated with PDM during oncologic resection.
• To emphasize strategies for mitigating surgical risks in PDM patients.

Main Methods:

• Retrospective review of 6 colorectal cancer cases involving PDM.
• Surgical procedures included lymph node dissection for sigmoid colon or rectal cancer.
• Assessment of surgical techniques, complications, and outcomes, with focus on vascular preservation and intraoperative imaging.

Main Results:

• Six cases of colorectal cancer surgery in the context of PDM were successfully managed.
• Adhesion dissection and preservation of the left colic artery (LCA) were key considerations.
• Indocyanine green (ICG) fluorescence imaging was utilized to ensure adequate blood supply.

Conclusions:

• Colorectal cancer surgery in patients with PDM requires careful planning and execution.
• Preservation of the LCA or utilization of ICG imaging is vital for maintaining anastomotic perfusion.
• These strategies help minimize the risk of intestinal injury and ischemia in complex PDM cases.