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The mesocolon a histological and electron microscopic characterization of the mesenteric attachment of the colon prior to and after surgical mobilization

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dc.contributor.author Culligan, Kevin
dc.contributor.author Walsh, Stewart R.
dc.contributor.author Dunne, Colum P.
dc.contributor.author Walsh, Michael T.
dc.contributor.author Ryan, Siobhan
dc.contributor.author Qyibdanattei, Fabio
dc.contributor.author Dockery, Peter
dc.contributor.author Coffey, Calvin J.
dc.date.accessioned 2016-02-18T11:39:51Z
dc.date.available 2016-02-18T11:39:51Z
dc.date.issued 2014
dc.identifier.citation Culligan, K,Walsh, S,Dunne, C,Walsh, M,Ryan, S,Quondamatteo, F,Dockery, P,Coffey, JC (2014) 'The Mesocolon A Histological and Electron Microscopic Characterization of the Mesenteric Attachment of the Colon Prior to and After Surgical Mobilization'. Annals Of Surgery, 260 :1048-1056. en_US
dc.identifier.uri http://hdl.handle.net/10344/4895
dc.description peer-reviewed en_US
dc.description.abstract Background: Colonic mobilization requires separation of mesocolon from underlying fascia. Despite the surgical importance of planes formed by these structures, no study has formally characterized their microscopic features. The aim of this study was to determine the histological and electron microscopic appearance of mesocolon, fascia, and retroperitoneum, prior to and after colonic mobilization.Methods: In 24 cadavers, samples were taken from right, transverse, descending, and sigmoid mesocolon. In 12 cadavers, specimens were stained with hematoxylin and eosin (3 sections) or Masson trichrome (3 sections). In the second 12 cadavers, lymphatic channels were identified by staining immunohistochemically for podoplanin. The ascending mesocolon was assessed with scanning electron microscopy. The above process was first conducted with the mesocolon in situ. The mesocolon was then surgically mobilized, and the process was repeated on remaining structures.Results: The microscopic structure of mesocolon and associated fascia was consistent from ileocecal to mesorectal level. A surface mesothelium and underlying connective tissue were evident throughout. Fibrous septae separated adipocyte lobules. Where apposed to retroperitoneum, 2 mesothelial layers separated mesocolon and underlying retroperitoneum. A connective tissue layer occurred between these (ie, Toldt's fascia). Lymphatic channels were evident both in mesocolic connective tissue and Toldt's fascia. After surgical separation of mesocolon and fascia both remained contiguous, the fascia remained in situ and the retroperitoneum undisturbed.Conclusions: The findings demonstrate that the contiguous mesocolon and retroperitoneum are separated by mesothelial and connective tissue layers. These properties generate the surgical planes (ie, meso-and retrofascial planes) exploited in colonic and mesocolic mobilization. en_US
dc.language.iso eng en_US
dc.publisher Lippincott Williams & Wilkins en_US
dc.relation.ispartofseries Annals of Surgery;260 (6), pp. 1048-56
dc.relation.uri http://dx.doi.org/10.1097/SLA.0000000000000323
dc.rights This is the author's accepted copy the final published version is available at http://dx.doi.org/10.1097/SLA.0000000000000323 en_US
dc.subject colon en_US
dc.subject histology en_US
dc.subject mesocolon en_US
dc.subject mobilization en_US
dc.subject surgery en_US
dc.title The mesocolon a histological and electron microscopic characterization of the mesenteric attachment of the colon prior to and after surgical mobilization en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.date.updated 2016-02-18T11:13:42Z
dc.description.version ACCEPTED
dc.identifier.doi 10.1097/SLA.0000000000000323
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 1576090
dc.internal.copyrightchecked Yes
dc.description.status peer-reviewed


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