关键词: 肠系膜下动脉, 　自主神经保护, 　解剖关系, 　结直肠癌

Abstract:

Objective　To explore the relationship between the root of inferior mesenteric artery and the autonomic nerves plexus around it for the autonomic nerves preservation in the colorectal surgeries.　Methods Gross and microscopic anatomy were performed on 7 formalin-fixed cadavers and the autonomic nerves preservation around the root of IMA in laparoscopic D3 radical excision for rectal cancer was imitated on 2 fresh cadavers.　Results　The bilateral trunk of the superior hypogastric plexus and communicating branches have intimate relationship with the root of inferior mesenteric artery. The right trunk runs relatively far away from the root of the inferior mesenteric artery under the anterior renal fascia. Above the level of the descending branches of the left trunk, the left trunk, the inferior mesenteric plexus and the abdominal aortic plexus run intimately on the left of the root of inferior mesenteric artery and continue with each other. Below it, the left trunk runs beneath the anterior renal fascia. The distance between the origin of inferior mesenteric artery and the descending branch of the left trunk is variable.　Conclusions　The right trunk of the superior hypogastric plexus and most bilateral communicating branches can be protected if the dissection is performed in the surgical plane anterior to the anterior renal fascia. The left trunk may be protected effectively if the descending branches of the left trunk are chosen as a new anatomical landmark for ligation of the inferior mesenteric artery.

Key words: Inferior mesenteric artery, Autonomic nerves preservation, Anatomic relationship, Colorectal cancer