Giuseppe Lo Re MD, Presenter: Nothing to Disclose

Massimo Galia MD, Abstract Co-Author: Nothing to Disclose

Rosaria Scarpinata, Abstract Co-Author: Nothing to Disclose

Ludovico La Grutta MD, Abstract Co-Author: Nothing to Disclose

Gianfranco Cocorullo, Abstract Co-Author: Nothing to Disclose

Massimo Midiri MD, Abstract Co-Author: Nothing to Disclose

Anastomotic leakage is a frequent complication of anterior resection in left-sided colon cancer. The blood supply of colorectal anastomosis site is essential to avoid the risk of anastomotic leakage, and the presence of an accessory middle colic artery, frequent variation rather of mesenteric vasculature, reduce this risk increasing the supply. Aim of this study is to evaluate the usefulness of Multi-detector Computed Tomography (MDCT)in the assessment of vascular anatomy of middle colic artery in order to reduce the risk of anastomotic leakage.

Between December 2006 and March 2007 70 patient (43 male, 27 female; mean age 68 years old) underwent curative surgery at our hospital. In all cases the MDCT was performed two days before the surgery. All scans were acquired at baseline and 30 and 75 seconds after intravenous administration of 110-130 ml non-ionic iodinated contrast medium at a rate of 4 mL/sec. After the axial images evaluation raw dataset were elaborated in a workstation with MPR, MIP and 3D VR algorithms to evaluate the mesenteric vasculature, particularly with reference to presence of an accessory middle colic artery. In case of absence of accessory middle colic artery the surgeon preserved a greater blood supply.

In all patients was possible to evaluate the mesenteric vascular anatomy. 61 patients (87%)  showed conventional mesenteric vascular anatomy, and 4 of them (6,5%) experienced anastomotic leakage. In 9 patients (13%) was possible to display an accessory middle colic artery, and no one of them experienced anastomotic leakage.

Preoperative MDCT assessment of vascular anatomy of middle colic artery is useful in anterior resection of left-sided colon cancer in order to reduce the risk of anastomotic leakage.

MDCT clearly reveals vascular anatomy of middle colic artery in preoperative evaluation, in order to reduce the risk of anastomotic leakage.

Lo Re, G, Galia, M, Scarpinata, R, La Grutta, L, Cocorullo, G, Midiri, M, 64-detector Computed Tomography in Reoperative Assessment of Vascular Anatomy of Middle Colic Artery in Left-sided Colon Cancer.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5015258.html