A PEROPERATIVE COMPARISON OF WESTERN AND ORIENTAL COLONIC ANATOMY ANDMESENTERIC ATTACHMENTS

It has been suggested that the Oriental colon is easier to colonoscope than its Western counterpart. The aim of this study was to investigat e possible differences in colonic anatomy between Western and Oriental patients that might explain this observation. Measurements of colonic length and mesenteric attachments were taken according to a set proto col from 115 Western (Caucasian) and 114 Oriental patients at laparoto my. Sigmoid adhesions were found more frequently in Western (17%) comp ared to Oriental (8%) patients, P=0.047, A descending mesocolon of gre ater than or equal to 10 cm occurred in 10 (8%) Western patients but o nly 1 (0.9%) Oriental patient, P=0.01. The splenic flexure was more fr equently mobile in Western patients (20%) compared to Oriental (9%) pa tients, P=0.016, In 29% - of Western patients the mid-transverse colon reached the symphysis pubis, or lower when pulled downwards in contra st to 10% of Oriental patients, P<0.001. There was no significant diff erence in total colonic length comparing Western (median = 114 cm, ran ge 68-159 cm) to Oriental (median = 111 cm, range 78-161 cm) patients. Western patients have a higher incidence of sigmoid colon adhesions a nd increased colonic mobility when compared to Orientals, These findin gs support the observation that colonoscopy is a more difficult proced ure in Western patients.