Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Order a digital copy of the thesis here
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Senior Consultant Karoline Horisberger, University Medical Center Mainz, Germany
- Second opponent: Senior Consultant Bjørn Steinar Olden Nedrebø, Haukeland University Hospital, Norway
- Third member and chair of the evaluation committee: Professor II Marianne Grønlie Guren, University of Oslo
Chair of the Defence
Professor Emeritus Trond Buanes, University of Oslo
Principal Supervisor
Medical Specialist Airazat M. Kazaryan, Oslo University Hospital
Summary
In recent decades, the focus of oncologic colorectal surgery has shifted from the colon itself to the mesentery, which contains the blood and lymphatic vessels that supply and drain the colon. Consequently, oncological radical procedures are now rightly called radical mesenterectomy instead of colectomy.
This shift necessitates a thorough understanding of the vascular anatomy of the vessels supplying the colon. For surgeons to deliver personalized and effective surgery, a deep knowledge of anatomy is essential. This thesis contributes significantly to our understanding of the vascular supply of the splenic flexure.
The thesis offers a detailed description of the 3D relationship between the origins of the middle colic artery (MCA) from the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA) from the aorta. This anatomical configuration has been termed the mesenteric inter-arterial stair. The authors propose that this stair can serve as a guide for performing radical mesenterectomy of the splenic flexure. The study also examines the accessory middle colic artery, present in one-third of patients, which poses a potential route for lymphatic spread and a surgical challenge. Additionally, the various possible positions of the middle colic artery bifurcation are detailed, emphasizing its importance in radical mesenterectomy procedures for cancers of the splenic flexure, transverse colon, and right colon. Finally, the thesis describes the different drainage patterns of the inferior mesenteric vein, suggesting that these patterns, along with the mesenteric inter-arterial stair, could guide the oncological resection of splenic flexure cancer.
A distinctive aspect of this study is the use of both 3D virtual and 3D-printed vascular models, allowing for an exceptionally detailed mapping of the vascular anatomy.
Additional information
Contact the research support staff.