The left colic artery: a comprehensive analysis.

Abstract

The anatomy of the left colic artery (LCA) is subject to a considerable level of variability, both in its origin, branching pattern, and location in the abdominal cavity. Due to this variability, many studies have tried to describe the vascular anatomy of this anatomical entity using various classifications. It is hoped that the results of the present study may aid surgeons in increasing their anatomical knowledge relevant to colorectal surgeries. A retrospective analysis, including 75 consecutive patients, was conducted to assess the anatomical and morphometric variations of the LCA. Finally, a total of 67 LCAs were included in this study. The majority of the LCA originated directly (N = 48; 71.64%) or indirectly via the colo-sigmoid trunk (N = 18; 26.87%) from the inferior mesenteric artery (IMA). The most common variation of the LCA, according to the Yada, or analogical Wang, classification, was found to be Type I (N = 28; 50.00%). The median diameter of the LCA at its origin was found to be 2.12 mm (LQ = 1.77; HQ = 2.51). The median cross-sectional area of the LCA at its origin was set to be 3.38 mm2 (LQ = 2.29; HQ = 4.33). In conclusion, this study provides a detailed analysis of the anatomical and morphometric variations of the LCA, offering valuable insights for improving the safety and effectiveness of colorectal surgeries, particularly during procedures involving ligation of the IMA. These results emphasize the need for thorough preoperative imaging and anatomical understanding to minimize the risk of iatrogenic injury. Preserving the LCA during low ligation of the IMA is shown to be crucial for maintaining adequate blood supply to the remaining bowel, reducing the risk of ischemia, and ensuring better patient outcomes.