| Objective(s): Yunnan Province is the only province with 26 ethnic groups at present.There is a big gap between ethnic minorities and the Han nationality in terms of lifestyle,social culture,diet structure,living environment and genetic background.In this paper,3D CT angiography and 3D vascular reconstruction are used to observe and analyze whether the branch variation rate of the inferior mesenteric artery in Yunnan has ethnic differences and whether the measured data of other vessels are also affected by other factors;To explore the specificity of its vascular distribution and anatomical structure and its clinical significance in radical resection of colorectal cancer(CRC).Methods: The clinical and imaging data of patients of various ethnic groups in Yunnan who underwent 3D CT angiography and 3D revascularization in the First Affiliated Hospital of Kunming Medical University from January 2020 to December2022 were selected.Among them,304 cases of Han nationality were collected;33cases of Yi nationality;23 cases of Hui nationality;1 case of Mongolian ethnicity;2cases of Dai ethnic group;21 cases of Miao and 5 cases of Tibet;21 cases of Bai ethnicity;1 case of Hani;A total of 411 cases(283 males,accounting for 68.9%,128 females,accounting for 31.1%),were collected in a total of 411 cases(283 males,accounting for 31.1%),and the age of enrollment was 18-82 years.Reconstruct images of inferior mesenteric arteries and their branching effects by 3D CT angigraphy.Classify IMA and measure the anatomical parameters of statistical IMA and branches;According to the Murono classification,IMA is divided into four categories,and the specific classification method is type I: LCA is issued independently from the backbone of IMA in the form of the first(LCA alone type),and rectal SRA is issued from SA;Type II: LCA and SA are issued in a co-point form(co-stem),SRA is issued separately;Type III: LCA,SA and SRA co-stem(co-point type);Type IV: lack of LCA(absent type).The distance between the root of the inferior mesenteric artery and the bifurcation point of the left and right iliac arteries(d1),and the distance from the root of the left colonic artery to the root of the inferior mesenteric artery(d2)were measured.Distance from the beginning of the upper inferior mesenteric artery to the left colonic artery in a cross-sectional cross-section of the root of the inferior mesenteric artery(d3).Then,the classification of submesenteric artery branches and the anatomical measurement data of each vessel(d1,d2,d3)were recorded,and finally the differences between IMA classification among Han and ethnic minorities in Yunnan were further analyzed,and the differences in d1,d2,d3,ethnicity,IMA classification and gender were further analyzed.All data in this study were statistically and analysed using the SPSS27.0software package.Results: According to the Murono classification,411 patients selected:1.IMA types are sorted according to the number of examples: Type I is the most,Type IV is second,followed by Type II and III.The specific classification and number of cases were as follows: Type I: a total of 168 cases,accounting for 40.9% of the total number of residents;There were 90 cases of type II,accounting for 21.9% of the total intakes;There were 39 cases of type III,accounting for 9.5% of the total admission;There were 114 cases of type IV,accounting for 27.7% of the total admissions.2.The proportion of type III in ethnic minority groups(15.9%)is higher,which is obviously different from the proportion of type III in Han people(7.3%).The specific number of classification cases was as follows: Han nationality accounted for 129 cases in Type I,accounting for 42.3% of the Han population,and ethnic minorities accounted for 39 cases,accounting for 36.5% of the population included in ethnic minorities.Type II accounted for 71 cases of Han ethnicity,accounting for 23.4% of the included population;ethnic minorities accounted for 19 cases;It accounts for 17.8per cent of the population included in ethnic minorities.Type III accounted for 22 cases of Han ethnicity,accounting for 7.3% of the included population,and ethnic minorities accounted for 17 cases;It accounts for 15.9 per cent of the population included in ethnic minorities.In Type IV,Han accounted for 82 cases,accounting for26.9% of the Han population,and ethnic minorities accounted for 32 cases;It accounts for 29.9 per cent of the population included in ethnic minorities.3.The distance(d1)from the root of the submesenteric artery to the bifurcation point of the left and right iliac arteries was related to sex(P<0.05),and the value was smaller in women.It has nothing to do with IMA typing,ethnicity.The mean value of d1 was(43.27±6.35)mm,of which the mean value of male was(43.71±6.20)mm and the mean value of female was(42.29±6.58)mm.4.The distance(d3)from the beginning of the upper inferior mesenteric artery to the left colon artery in the cross-section of the root of the submesenteric artery was related to sex(P<0.05),and the value was smaller in women.It has nothing to do with IMA typing,ethnicity.The mean D3 was(25.95±5.31)mm,of which the mean value of male was(26.46±5.48)mm and the mean value of female was(24.89±4.76)mm.5.The distance from the root of the left colonic artery to the root of the inferior mesenteric artery(d2)is related to IMA typing(P<0.05);The larger the number of fractions,the longer the length of D2.It has nothing to do with gender,ethnicity.The mean d2 was(38.12±8.37)mm,and the mean was 38.12±8.37 mm.The mean value of type I was(37.06±8.9)mm,the mean value of type II was(38.99±7.49)mm,and the mean value of type III was(40.63±7.40)mm.Conclusion(s):1.The proportion of type IV(27.7%)in submesenteric artery classification in Yunnan was higher than that of type IV in other regions(<5%);Generally the lowest percentage).2.The proportion of type III among ethnic minorities(15.9%)is higher than that among Han(7.3%).Type III has a special anatomical structure,and it is easy to damage the costem point and IMA trunk when dissecting blood vessels,and the intraoperative treatment should be more meticulous.3.The length of D1 and D3 is related to gender,and the length is shorter in women.The shorter the length of d1 and d3,the more difficult it is to expose blood vessels during surgery,and colorectal cancer surgery that retains LCA should pay more attention to protecting LCA.4.The length of d2 is related to IMA classification,and the length of d2: type III>type II> type I.The length of d2 is estimated by the relationship between d2 and IMA typing,which has a guiding effect on the individualized treatment of colorectal cancer patients with different IMA types. |
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