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Meta-Analysis
. 2023 Jul;25(7):1361-1370.
doi: 10.1111/codi.16624. Epub 2023 Jun 14.

Discontinuity of marginal artery at splenic flexure and rectosigmoid junction: A systematic review and meta-analysis

Roberto Cirocchi  1 , Justus Randolph  2 , Isaac Cheruiyot  3   4 , R Justin Davies  5   6 , Sara Gioia  7 , Brandon Michael Henry  8 , Gabriele Anania  9 , Annibale Donini  1 , Andrea Mingoli  10 , Paolo Sapienza  10 , Stefano Avenia  1
Affiliations
Meta-Analysis

Discontinuity of marginal artery at splenic flexure and rectosigmoid junction: A systematic review and meta-analysis

Roberto Cirocchi et al. Colorectal Dis. 2023 Jul.

Abstract

Aim: The aim of this study was to provide comprehensive evidence-based assessment of the discontinuity of the marginal artery at the splenic flexure (SF) and the rectosigmoid junction (RSJ).

Method: A systematic review was conducted of literature published to 26 December 2022 in the electronic databases PubMed, SCOPUS and Web of Science to identify studies eligible for inclusion. Data were extracted and pooled into a meta-analysis using the Metafor package in R. The primary outcomes were the pooled PPEs of the marginal artery at the SF and the RSJ. The secondary outcome was the size of vascular anastomoses.

Results: A total of 21 studies (n = 2,864 patients) were included. The marginal artery was present at the splenic flexure in 82% (95% CI: 62-95) of patients. Approximately 81% (95% CI: 63-94%) of patients had a large macroscopic anastomosis, while the remainder (19%) had small bridging ramifications forming the vessel. The marginal artery was present at the RSJ in 82% (95% CI: 70-91%) of patients.

Conclusion: The marginal artery may be absent at the SF and the RSJ in up to 18% of individuals, which may confer a higher risk of ischaemic colitis. As a result of high interstudy heterogeneity noted in our analysis, further well-powered studies to clarify the prevalence of the marginal artery at the SF and the RSJ, as well as its relationship with other complementary colonic collaterals (intermediate and central mesenteric), are warranted.

Keywords: Griffith's point; Sudeck's point; colon ischaemia; marginal artery.

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References

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