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Contributing factors include a long ileal mesentery, a long and narrow-based mesosigmoid, a heavy meal or high fluid intake after a long period of fasting, and a floating caecum.
These patients usually have short segment Hirschsprung's disease and if the mesosigmoid is freely mobile, the dilated ganglionic sigmoid colon twist forming a sigmoid volvulus.
Involvement of the mesosigmoid and the right paracolic gutter is less frequent.
* The mesosigmoid is divided with an ultrasonic device.
While the anterior CRM is located only in the most distal part of the specimen, the posterior CRM has a triangular shape and extends to the mesosigmoid. A positive CRM is defined as continuous or discontinuous tumor extension or the presence of a positive lymph node within 1 mm of the radial, nonperitonealized soft tissue edge.
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