Anatomy
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
The venous drainage of the rectum mirrors the arterial supply. From a rich and valveless intramural venous plexus, blood enters the perirectal venous plexus, from where rectal blood is carried mainly in the superior rectal vein. The superior rectal vein, running alongside the artery, crosses the pelvic brim from below upward to become the inferior mesenteric vein. Thereafter, the inferior mesenteric vein drains the sigmoid, descending colon and splenic flexure before emptying into the splenic vein and thereby into the portal vein. Some venous blood from the intramural and perirectal venous plexuses travels bilaterally in the middle rectal veins and drains into the internal iliac veins. These veins are usually multiple and small, but can occasionally be large and require ligation. Venous blood from these rectal plexuses also finds its way through the anal wall into the inferior rectal veins which drain into the internal iliac veins via the internal pudendal veins. The anal mucosa and submucosa thus represent sites of natural porta-systemic venous anastomoses. To a limited extent, these anastomoses are also present in the rectal wall. Rarely they can give rise to life-threatening rectal bleeding in patients with portal hypertension.
Mesenteric vein thrombosis
Peter Gloviczki, Michael C. Dalsing, Bo Eklöf, Fedor Lurie, Thomas W. Wakefield, Monika L. Gloviczki in Handbook of Venous and Lymphatic Disorders, 2017
The incidence of MVT in the general population is poorly defined, but seems to be rather uncommon. Kazmers noted that MVT may be found in as few as one in 1000 laparotomies.5 The incidence of MVT has increased in Sweden from 2.0 per 100,000 patient-years between 1970 and 1982 to 2.7 per 100,000 patient-years between 2000 and 2006.6 The age at presentation varies from 45 to 80 years and both genders are equally represented.3,5–14 Venous thrombosis may be limited to the mesenteric veins or may propagate to or from other regional vessels.6–8,14 MVT accounts for 5%–15% of patients with intestinal ischemia.9–12 The clinical course and symptomatology is determined by both the aggression of the thrombotic process and the extent of venous segments involved, determining the possibility of collateral circulation development. The superior mesenteric vein is much more frequently involved relative to the inferior mesenteric vein.10
Robotic Colonic Cancer Surgery
Haribhakti Sanjiv in Laparoscopic Colorectal Surgery, 2020
Procedure: Sigmoid colectomy is relatively simpler and is performed in a fashion similar to laparoscopy. The sigmoid mesentery is lifted up and the inferior mesenteric artery is identified, clipped, and cut. Next, the inferior mesenteric vein is encountered more laterally and is dealt with similarly (Figure 30.6). Then the dissection is begun in the mesentery, which should have opened up with the pneumoperitoneum. Medial to lateral dissection is done, taking care not to injure the left ureter. The superior and inferior dissections performed similarly, and the desired level of dissection is obtained. After division of the bowel ends using staplers, the specimen is extracted through a small Pfannensteil incision or through the stoma site (if planned) after applying a wound protector. Depending on the level of inferior dissection, the anastomosis can either be performed with a linear or circular stapler.
Pre-, Peri-, and Postoperative Intravenous Ropivacaine versus that of Lidocaine for Analgesia after Hand-Assisted Laparoscopic Surgery of Left Colon Cancer: A Retrospective Analysis
Published in Journal of Investigative Surgery, 2021
Xiafang Gu, Chengjiao Xiao
Patients were instructed to lay down on the supine position before anesthesia on the bed. A 5.5 cm transumbilical incision was performed by surgeon and laparoscopy port (Phoenix Instruments Inc., Naperville, IL, USA) was inserted. Under the control of the hand, 4.5 cm trocar (Phoenix Instruments Inc., Naperville, IL, USA) was inserted in the left lateral quadrant above and toward the midline from the anterior superior iliac spine and 9.5 cm trocar (Phoenix Instruments Inc., Naperville, IL, USA) was inserted toward the right midclavicular above the umbilicus. A 11.5 cm trocar (Phoenix Instruments Inc., Naperville, IL, USA) was inserted toward the right anterior superior iliac spine. The inferior mesenteric vein and artery mobilized and ligated with the clip (Phoenix Instruments Inc., Naperville, IL, USA). The part of the colon was removed by incision and anastomosis was performed laparoscopically by a double-stapling technique using circular staples. The stitches were took on the skin by a suture (F. Hoffmann-La Roche Ltd, Basel, Switzerland) [1]. All procedures were performed by the general surgeon (minimum 4 years’ experience of laparoscopic colon surgeries) of the institutes. All instruments were USFDA approved.
Effects of resistance training on liver structure and function of aged rats
Published in The Aging Male, 2018
Ricardo Aparecido Baptista Nucci, Ana Caroline de Souza Teodoro, Walter Krause Neto, Wellington de Assis Silva, Romeu Rodrigues de Souza, Carlos Alberto Anaruma, Eliane Florencio Gama
We can see that the absolute weight of the liver did not change with RT. In order to have no doubts about these results, we performed the relative liver weight, established by the ratio of the total liver weight (absolute weight) divided by the final BW of the animal times 100. Regarding to the relative liver weight (Figure 1(C)), we observed that RT is a factor that decreases liver mass. Additionally, in Figure 2, we suggest, using LPC % and NLP %, that RT may reduce blood flow in the liver. According to van Wijck et al. [16] these results may be related to splanchnic hypoperfusion. Drainage of the splanchnic area is covered by the superior mesenteric vein, inferior mesenteric vein, and the portal vein, which return the venous blood to the heart via the liver and subsequently the inferior vena cava [16,17]. The splanchnic vasculature promotes vasodilatation or constriction via regulation of the mesenteric vascular resistance by neuroendocrine, humoral, and paracrine mechanisms [16,18]. During exercise, the release of norepinephrine near the α-adrenoreceptors of the sympathetic nervous system induces splanchnic vasoconstriction, thereby increasing total splanchnic vascular resistance [16,17,19,20]. The blood is rapidly redistributed from the splanchnic area to be used for the perfusion of tissues with increased activity during exercise, such as heart, lungs, active muscle, and skin [16,21,22].
Quality of life after total pancreatectomy with islet autotransplantation for chronic pancreatitis in Japan
Published in Islets, 2023
Tadashi Takaki, Daisuke Chujo, Toshiaki Kurokawa, Akitsu Kawabe, Nobuyuki Takahashi, Kyoji Ito, Koji Maruyama, Fuyuki Inagaki, Koya Shinohara, Kumiko Ajima, Yzumi Yamashita, Hiroshi Kajio, Mikio Yanase, Chihaya Hinohara, Makoto Tokuhara, Yukari Uemura, Yoshihiro Edamoto, Nobuyuki Takemura, Norihiro Kokudo, Shinichi Matsumoto, Masayuki Shimoda
After isolation of the islets, a 5-Fr angiocatheter was inserted into the inferior mesenteric vein under direct vision and the tip was placed in the main portal vein. The isolated islets were suspended in 200 mL of a solution containing 10% human albumin and heparin (70 U per kg body weight) and infused into the portal vein. The portal vein pressure was monitored at the beginning, middle, and end of the islet infusion. Intravenous or subcutaneous heparin was continued for 1 week postoperatively to prevent thromboembolism. Doppler ultrasonography of the portal vein was performed within 24 h after transplantation to confirm portal blood flow. The blood glucose level was maintained at 80–110 mg/dL by an artificial pancreas intraoperatively and for several hours postoperatively to protect the transplanted islets.32
Related Knowledge Centers
- Pancreas
- Sigmoid Colon
- Splenic Vein
- Superior Mesenteric Vein
- Blood
- Blood Vessel
- Rectum
- Large Intestine
- Body
- Portal Vein