Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Anatomy of Inferior Mesenteric artery: A cadaveric study(Anatomical Society of Sri Lanka, 2024) Abeysuriya, V.; Hewawardhane, S.Introduction: A comprehensive knowledge of the varied anatomy of the inferior mesenteric artery (IMA) can be important in surgeries in the region of the colon and rectum. Methods: We analyzed 50 fresh cadavers in the department of Anatomy, Faculty of Medicine Ragama from 2022 to 2024. Latarjet’s classification was used for the IMA branching pattern. The anatomical relationships of the IMA left colic artery (LCA), sigmoidal artery (SA), and superior rectal artery (SRA) were observed, and the length from the origin of the IMA to the point of branching into the LCA or common trunk of LCA and SA was measured. The relationship between LCA and inferior mesenteric vein (IMV) was also observed. The data was presented as the value / percentage. Results: Majority showed Type A branching pattern 35/50 (70%). The respective lengths from the origin of the IMA to the beginning of LCA were measured and expressed as (mm) (mean ± SD) for each type; Type A 33.4 ± 4.7, Type B 36.5 ± 5.4, Type C 39.2 ± 8.6. The number of LCA under IMV in type A (51%); type B (54%); type C (62%) respectively. There was no statistically significant difference among the three types. Conclusion: Our study showed that type A branching pattern of LCA was the commonest. It is also observed that almost similar incidence of LCA traversing above and beneath the IMV.Item Proximal and distal rectal cancers differ in curative resectability and local recurrence(Baishideng Publishing Group, 2011) Wijenayake, W.; Perera, M.; Balawardena, J.; Deen, R.; Wijesuriya, S.R.; Kumarage, S.K.; Deen, K.I.AIM: To evaluate patients with proximal rectal cancer (PRC) (> 6 cm up to 12 cm) and distal rectal cancer (DRC) (0 to 6 cm from the anal verge). METHODS: Two hundred and eighteen patients (120 male, 98 female, median age 58 years, range 19- 88 years) comprised 100 with PRC and 118 with DRC. The proportion of T1, T2 vs T3, T4 stage cancers was similar in both groups (PRC: T1+T2 = 29%; T3+T4 = 71% and DRC: T1+T2 = -31%; T3+T4 = 69%). All patients had cancer confined to the rectum - those with synchronous distant metastasis were excluded. Surgical resection was with curative intent with or without preoperative chemoradiation (c-RT). Follow-up was for a median of 35 mo (range: 12 to 126 mo). End points were: 30 d mortality, complications of operation, microscopic tumour- free margins, resection with a tumourfree circumferential margin (CRM) of 1 to 2 mm and > 2 mm, local recurrence, survival and the permanent stoma rate. RESULTS: Overall 30-d mortality was 6% (12): PRC 7 % and DRC 4%. Postoperative complications occurred in 14% with PRC compared with 21.5% with DRC, urinary retention was the complication most frequently reported (PRC 2% vs DRC 9%, P = 0.04). Twelve percent with PRC compared with 37% with DRC were subjected to preoperative c-RT (P = 0.03). A tumour-free CRM of 1 to 2 mm and > 2 mm was reported in 93% and 82% with PRC and 88% and 75% with DRC respectively (PRC vs DRC, P > 0.05). However, local recurrence was 5% for PRC vs 11% for DRC (P < 0.001). Three and five years survival was 65.6% and 60.2% for PRC vs 67% and 64.3% for DRC respectively. No patient with PRC and 23 (20%) with DRC received an abdomino-perineal resection. CONCLUSION: PRC and DRC differ in the rate of abdomino-perineal resection, post-operative urinary retention and local recurrence. Survival in both groups was similar.