[Laparoscopic radical resection of rectal cancer with preservation of the left colic artery: anatomical basis and surgical experience]

Assessing anatomical variations of the inferior mesenteric artery via three-dimensional CT angiography and laparoscopic colorectal surgery: a retrospective observational study

To assess the anatomy of the inferior mesenteric artery (IMA) and its branches by reviewing laparoscopic left-sided colorectal cancer surgery videos and comparing them with preoperative three-dimensional computed tomography (3D-CT) angiography, to verify the accuracy of 3D-CT vascular reconstruction techniques. High-definition surgical videos and preoperative imaging data of 200 patients who underwent laparoscopic left-sided colorectal cancer surgery were analysed, and the alignment of the IMA and its branches in relation to the inferior mesenteric vein (IMV) was observed and summarized. The above two methods were used to measure the length of the IMA and its branches. Of 200 patients, 47.0% had the sigmoid arteries (SAs) arise from the common trunk with the superior rectal artery (SRA), and 30.5% had the SAs arise from the common trunk with the left colic artery (LCA). In 3.5% of patients, the SAs arising from both the LCA and SRA. The LCA, SA, and SRA emanated from the same point in 13.5% of patients, and the LCA was absent in 5.5% of patients. The range of D cm (IMA length measured by intraoperative silk thread) and d cm (IMA length measured by 3D-CT vascular reconstruction) in all cases was 1.84-6.62 cm and 1.85-6.52 cm, respectively, and there was a significant difference between them. (p < 0.001). The lengths between the intersection of the LCA and IMV measured intraoperatively were 0.64-4.29 cm, 0.87-4.35 cm, 1.32-4.28 cm and 1.65-3.69 cm in types 1A, 1B, 1C, and 2, respectively, and there was no significant difference between the groups (p = 0.994). There was only a significant difference in the length of the IMA between the 3D-CT vascular reconstruction and intraoperative observation data, which can provide guidance to surgeons in preoperative preparation.

The significance of anatomical variation of the inferior mesenteric artery and its branches for laparoscopic radical resection of colorectal cancer: a review

Currently, high or low ligation of the inferior mesenteric artery (IMA) is a controversial issue in laparoscopic radical surgery for colorectal cancer. High or low ligation of the IMA has both advantages and disadvantages, and the level of ligation during the left colon and/or rectum resection has been a dilemma for surgeons. One important factor influencing the surgeon's decision to ligate the IMA in a high or low position is the anatomical type of the IMA and its branches. Some studies confirm that the anatomy of the IMA and its branches is critical to the anastomotic blood supply and, therefore, influences the choice of surgical approach (level of ligation of the IMA). However, many vascular variations in the anatomy of the IMA and its branches exist. Herein, we have summarized the anatomical types of the IMA and its branches, finding that the classification proposed by Yada et al. in 1997 is presently accepted by most scholars. Based on Yada's classification, we further summarized the characteristics of the IMA's various anatomical types as a guide for high or low ligation in radical colorectal cancer surgery.

Adoption of Artificial Intelligence (AI)-Based Computerized Tomography (CT) Evaluation of Comprehensive Nursing in the Operation Room in Laparoscopy-Guided Radical Surgery of Colon Cancer

This research aimed to discuss the application of traditional nonlocal mean (NLM) algorithm-based computerized tomography (CT) images in intervention evaluation of the nursing for patients performing laparoscopy-guided radical surgery of colon cancer. A total of 100 patients who were diagnosed with colon cancer after enteroscopy and performed laparoscopic radical surgery were chosen as the research objects. They were divided into an observation group (comprehensive nursing in operation room) and a control group (routine nursing), each of which included 50 cases. All cases received CT examination. Meanwhile, the improved traditional NLM (INLM) algorithm was proposed, and the effects of image reconstruction were analyzed to improve the quality of CT images. The result showed that structural similarity index measure (SSIM) and figure of merit (FOM) of INLM were obviously higher than those of filtered back projection (FBP) algorithm and NLM algorithm, and the average running time was significantly less than that of FBP algorithm and NLM algorithm (P < 0.05). The operation time and the amount of intraoperative blood loss of patients in the observation group were both less than those of patients in the control group, and differences had statistical significance (P < 0.05). Besides, the time of getting out of bed, ventilation recovery time, postoperative meal time, stomach tube encumbrance time, and catheter encumbrance time of patients in the observation group were all less than those of patients in the control group, and the differences had statistical significance (P < 0.05). In the observation group, there were 3 cases with postoperative complications, and 2 out of them got incision infection while 1 suffered from constipation. In contrast, there were 9 cases with postoperative complications in the control group, 3 of which were patients with incision infection, and 2 suffered from urinary retention while the other 4 suffered from constipation. According to the above results, the INLM algorithm proposed in this research could improve the image reconstruction accuracy of traditional algorithm, shorten the running time, and enhance the overall diagnostic efficiency. The comprehensive nursing in operation room with laparoscopic radical surgery of colon cancer could improve the cure rate and prognosis of patients, so it was worthy of clinical promotion and application.