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Three-dimensional computed tomography for analyzing the vascular anatomy in laparoscopic surgery for right-sided
Keitaro Hirai1, Daisuke Yoshinari, Hiroomi Ogawa
1Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
Insights
This study used 3D-CT to map mesenteric vessels in right-sided colon cancer. Understanding the varied anatomy of the superior mesenteric vein (SMV) and its arteries is crucial for safe surgery.
Area of Science:
- Surgical Anatomy
- Vascular Anatomy
- Colorectal Surgery
Background:
- Mesenteric vessels exhibit diverse branching patterns.
- Understanding these variations is critical for surgical planning.
- Anatomical relationships of key vessels in right-sided colon cancer require clarification.
Purpose of the Study:
- To clarify the anatomical relationship between the superior mesenteric vein (SMV), right colic artery (RCA), and ileocolic artery (ICA).
- To examine the relationship between the RCA and the right colic vein (RCV).
- To provide detailed anatomical insights for right-sided colon cancer surgery.
Main Methods:
- Utilized 3-dimensional computed tomography (3D-CT) for detailed anatomical visualization.
- Analyzed 100 consecutive cases of colorectal cancer patients who underwent multidetector computed tomography (MDCT) prior to laparoscopic surgery.
- Combined arterial angiography, venous angiography, colonography, tumor, lymph node, and duodenal images to create 3D-CT reconstructions.
Main Results:
- The RCA originated from the superior mesenteric artery (SMA) in 37% of cases.
- The ileocolic artery (ICA) course relative to the SMV was documented (anterior/posterior).
- The right colic vein (RCV) drainage patterns into the SMV or gastrocolic trunk were identified.
Conclusions:
- The study successfully clarified the anatomical variations of mesenteric vessels in right-sided colon cancer.
- Preoperative 3D-CT imaging is valuable for understanding complex vascular anatomy.
- This anatomical knowledge enhances surgical safety and precision in oncological procedures.
Background:
The mesenteric vessels have many branching patterns. This study clarified the anatomic relationship between the superior mesenteric vein (SMV), the right colic artery (RCA), and the ileocolic artery (ICA) using 3-dimensional computed tomography (3D-CT). The relationship between the RCA and the right colic vein (RCV) was also examined.
Methods:
Between April 2006 and July 2011, all patients with colorectal cancer underwent multidetector computed tomography (MDCT) before laparoscopic surgery. The 100 most recent consecutive cases were analyzed. 3D-CT images were made by combining arterial angiography, venous angiography, colonography, tumor, lymph node, and duodenal images.
Results:
The RCA branched from the SMA in 37 cases (37%); of these, 21 had an ICA that crossed anterior to the SMV and 16 had an ICA that crossed posterior. When the ICA crossed anterior to the SMV, all had an RCA that crossed anterior to the SMV, and no posterior RCA was seen. Furthermore, the RCV joined the SMV in 10 cases (27%) and the gastrocolic trunk in 27 cases (73%).
Conclusions:
Our study clarified the anatomic variety of the vessels in right-sided colon cancer. Preoperative 3D-CT is useful for understanding the anatomy to ensure a safe, precise operation.
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