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Inferior Mesenteric Artery (inferior + mesenteric_artery)
Selected AbstractsRole of intra-arterial steroid administration in the management of steroid-refractory acute gastrointestinal graft-versus-host disease,AMERICAN JOURNAL OF HEMATOLOGY, Issue 12 2006Arafat Tfayli Abstract We report here a case of severe steroid-refractory gastrointestinal graft-versus-host disease treated with intra-arterial administration of corticosteroids. A 53-year-old female with non-Hodgkin's lymphoma received peripheral blood hematopoietic stem cell transplant from her HLA-matched sibling. She developed grade II skin and grade IV gastrointestinal graft-versus-host disease with no hepatic involvement. Therapy with oral prednisone easily controlled her skin rash but she had profuse diarrhea that did not respond to high dose intravenous corticosteroids and denileukin diftitox. Infusion of methyl-prednisolone into superior and inferior mesenteric arteries produced dramatic improvement of diarrhea, with complete resolution of gastrointestinal graft-versus-host disease. Am. J. Hematol., 2006, © 2006 Wiley-Liss, Inc. [source] Rare case of the inferior mesenteric artery and the common hepatic artery arising from the superior mesenteric arteryCLINICAL ANATOMY, Issue 6 2004Tokuji Osawa Abstract We found a case in which inferior mesenteric artery and the common hepatic artery arose from the superior mesenteric artery, forming the common hepatomesenteric trunk, during a routine dissection carried out at Iwate Medical University in 2002. This variation is rare, but can be embryonically explained. A change in the positions of the disappearance of the ventral splanchnic arteries and the longitudinal anastomotic channel results in variations in the system of arteries distributed to the digestive organs. In the present case, the longitudinal anastomotic channel between the superior and the inferior mesenteric arteries survived to form the common mesenteric artery, which was joined by the common hepatic artery, forming the common hepatomesenteric trunk. Clin. Anat. 17:518,521, 2004. © 2004 Wiley-Liss, Inc. [source] Our experience with third renal transplantation: Results, surgical techniques and complicationsINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2007Mohammad Hossein Nourbala Background: Despite the popularity of kidney transplantation in the current era, second and third kidney transplantation are not yet widely accepted and practiced. Each center has its own regulations and experiences and there is no accepted protocol for third kidney transplantation. We report here our 15 years of experience with third kidney transplantation. Methods: This is a report of all the third kidney transplantations performed in Baqiyatallah Hospital, Tehran, Iran, between 1991 and 2006. Demographic data, surgical techniques, complications and outcomes are reported. Results: Of the nine third kidney transplant patients, six were male. The median age was 43 years (32,52). All of the patients received kidney from living donors. All operations were performed by a midline incision and the grafts were placed at the midline, in the intraperitoneal space. For arterial anastomosis, we used internal iliac, right common iliac and both the right external iliac and inferior mesenteric artery in 4, 4 and 1 case(s), respectively. For venous anastomosis, we used vena cava, common iliac and external iliac veins in 3, 5 and 1 case(s), respectively. During the follow up period (38 months), 6 grafts (66.6%) were functioning. None of the graft rejections were due to surgical complications. Wound dehiscence occurred in two patients. No other surgical complications including infection, lymphocele or hemorrhage were observed. Conclusion: Third kidney transplantation is a field that has not been fully explored. The rate of complications seems to be not much higher than the first transplantation. Defining a standard protocol seems necessary. [source] Lymph node mapping in patients with bladder cancer undergoing radical cystectomy and lymph node dissection to the level of the inferior mesenteric arteryBJU INTERNATIONAL, Issue 2 2010Jørgen B. Jensen Study Type , Therapy (case series) Level of Evidence 4 OBJECTIVE To evaluate extended lymph node dissection (LND) as a nodal staging tool in the treatment of invasive carcinoma of the urinary bladder and to suggest a reasonable proximal limit of the dissection. PATIENTS AND METHODS In all, 170 patients underwent radical cystectomy with extended LND up to the level of the inferior mesenteric artery. Specimens were evaluated as 13 separate packages from pre-designated anatomical locations. The number of LNs and presence of positive LNs (LN+) at each location was prospectively registered. RESULTS The median (range) number of LNs removed was 24 (6,62). In all, 25.3% of the patients had LN+. The median (range) number of LN+ was 2 (1,20). Advanced T-stage was correlated with a higher risk of LN+ but not to the specific location of the LN+. Two patients had LN+ above the common iliac bifurcation with no LN+ more distally located within the pelvic region. All other patients with LN+ above the common iliac bifurcation had more distally located LN+. There were no skip lesions to LNs above the aortic bifurcation. CONCLUSIONS Extended LND above the common iliac bifurcation including the presacral area provides a more accurate LN staging compared with a standard pelvic LND. Extending the limits above the aortic bifurcation is not necessary from a staging perspective. [source] Regional lymph node dissection in the treatment of renal cell carcinoma: is it useful in patients with no suspected adenopathy before or during surgery?BJU INTERNATIONAL, Issue 3 2001A. Minervini Objectives To evaluate the role of regional lymph node dissection (LND) in a series of patients with renal cell carcinoma (RCC) with no suspicion of nodal metastases before or during surgery. Patients and methods A series of 167 patients with RCC, free from distant metastases at diagnosis, and who underwent radical nephrectomy at our hospital between January 1990 and October 1997, was reviewed. The mean (median, range) follow-up was 51 (45, 19,112) months. Of the 167 patients, 108 underwent radical nephrectomy alone and 59 had radical nephrectomy with regional LND limited to the anterior, posterior and lateral sides of the ipsilateral great vessel, from the level of the renal pedicle to the inferior mesenteric artery. Of these 59 patients, 49 had no evidence of nodal metastases before or during surgery. The probability of survival was estimated by the Kaplan,Meier method, using the log-rank test to estimate differences among levels of the analysed variables. Results The overall 5-year survival was 79%; the 5-year survival rate for the 108 patients who underwent radical nephrectomy alone was 79% and for the 49 who underwent LND was 78%. Of the 49 patients with no suspicion of lymph node metastases, one (2%) was found to have histologically confirmed positive nodes. Conclusion These results suggest that there is no clinical benefit in terms of overall outcome in undertaking regional LND in the absence of enlarged nodes detected before or during surgery. [source] Survival benefit of high ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery (Br J Surg 2006; 93: 609,615)BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2006D. Pandey No abstract is available for this article. [source] Authors' reply: survival benefit of high ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery (Br J Surg 2006; 93: 609,615)BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2006Y. Kanemitsu No abstract is available for this article. [source] Survival benefit of high ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2006Y. Kanemitsu Background: The aim of this study was to assess the impact of inferior mesenteric artery (IMA) root nodal dissection before high ligation of the artery on survival in patients with sigmoid colon or rectal cancer. Methods: Data on 1188 consecutive patients who underwent resection for sigmoid colon or rectal cancer, with high ligation of the IMA, were identified from a prospective database (April 1965 to December 1999). Survival of patients with involvement of nodes along the IMA proximal to the origin of the left colic artery (root nodes, station 253) through the bifurcation of the superior rectal artery (trunk nodes, station 252) was determined. Results: Twenty patients (1·7 per cent) had metastatic involvement of station 253 lymph nodes and 99 (8·3 per cent) had metastases to station 252. The 5- and 10-year survival rates of patients with metastases to station 253 were 40 and 21 per cent, and those for patients with metastases to station 252 were 50 and 35 per cent, respectively. Conclusion: High ligation of the IMA allows curative resection and long-term survival in patients with cancer of the sigmoid colon or rectum and nodal metastases at the origin of the IMA. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Rare case of the inferior mesenteric artery and the common hepatic artery arising from the superior mesenteric arteryCLINICAL ANATOMY, Issue 6 2004Tokuji Osawa Abstract We found a case in which inferior mesenteric artery and the common hepatic artery arose from the superior mesenteric artery, forming the common hepatomesenteric trunk, during a routine dissection carried out at Iwate Medical University in 2002. This variation is rare, but can be embryonically explained. A change in the positions of the disappearance of the ventral splanchnic arteries and the longitudinal anastomotic channel results in variations in the system of arteries distributed to the digestive organs. In the present case, the longitudinal anastomotic channel between the superior and the inferior mesenteric arteries survived to form the common mesenteric artery, which was joined by the common hepatic artery, forming the common hepatomesenteric trunk. Clin. Anat. 17:518,521, 2004. © 2004 Wiley-Liss, Inc. 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