The intestinal contents take about 18 to 36 hours to journey through the colon in the process, the few remaining nutrients are snatched into the bloodstream and much of the water is absorbed, resulting in solid fecal material. From there, digested material travels up the ascending colon, across the transverse colon, and down the descending colon to the final portion, the sigmoid colon, in the lower left part of the abdomen. Residual material enters the colon, or large intestine, in the cecum, which lies in the right lower portion of the abdomen (see Figure 1). The food you eat is mostly digested in the stomach and small intestine. The colon is a 4 1/2-foot-long tube that constitutes the final portion of the intestinal tract. It's a learning experience that's particularly unfortunate, since diverticular disease is largely preventable. Still, when complications develop, blissful ignorance about diverticulosis abruptly gives way to an unwelcome education about the pain of diverticulitis or the bleeding of diverticulosis. That's understandable, since the most prevalent form of the problem, diverticulosis, produces few if any symptoms. But few of these well-informed gents can tell you if they have diverticular disease of the colon, even though it's an extremely common condition. Many health-conscious peoplemen can recite their cholesterol counts and, blood pressure readings, and PSA levels without even glancing at their medical records. 2009 11:354–64.Learn about diverticulitis and how diverticular disease is largely preventable Standardized surgery for colonic cancer: complete mesocolic excision and central ligation–technical notes and outcome. Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S. Survival outcomes following laparoscopic versus open D3 dissection for stage II or III colon cancer (JCOG0404): a phase 3, randomised controlled trial. Kitano S, Inomata M, Mizusawa J, Katayama H, Watanabe M, Yamamoto S, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. 2007 25:3061–8.īuunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, et al. A comparison of laparoscopically assisted and open colectomy for colon cancer. Nelson H, Sargent DJ, Wieand HS, Fleshman J, Anvari M, Stryker SJ, et al. A comprehensive preoperative knowledge of the branching patterns of the middle colic artery and left colic artery and the presence of collateral arteries would be helpful in surgery for colon cancer in the splenic flexure.Īccessory middle colic artery Anatomy Left colic artery Riolan’s arch Splenic flexure. The frequency was found to vary widely across studies, partially due to the ambiguous definition of Riolan's arch. The reported frequency of Riolan's arch was 7.5-27.8%. The accessory middle colic artery was present in 6.7-48.9% of cases and was present in > 80% of cases without a left colic artery. The left colic artery was absent in 0-7.5% of cases. The middle colic arteries were reported to arise independently without forming a common trunk in 8.9-33.3% of cases. After screening of full texts, 33 studies were selected. We searched the PubMed database for studies on the vascular anatomy of the splenic flexure that were published from January 1990 to October 2020. We reviewed the patterns of vascular anatomy and the definition of the vessels around the splenic flexure. Surgical treatment of the transverse colon is difficult because of the many variations of blood vessels.
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