A Case of Robot-Assisted Ileocecal Resection for Ascending Colon Cancer with Ileocolic Vein Flowing into the Jejunal...

Anatomical vascular variations are frequently observed in the right colon. The ileocolic vein (ICV) typically drains directly into the superior mesenteric vein (SMV). When vascular anomalies are present, surgical procedures often differ from standard techniques, which frequently increases the difficulty of the operation. Therefore, preoperative confirmation of vascular variations is essential. Here, we present a case of ascending colon cancer in which a rare variation in the ICV was diagnosed preoperatively.

An 84-year-old woman visited her physician complaining of hematochezia and was diagnosed with ascending colon cancer by colonoscopy. She was then referred to our hospital for surgical treatment. Preoperative CT revealed that the ICV had drained into the jejunal vein (JV) instead of the SMV. The patient underwent robot-assisted ileocecal resection. Intraoperatively, it was confirmed that the ICV drained into the JV, which ran on the dorsal side of the SMV, consistent with the preoperative imaging findings. The ICV was ligated at the level of the right SMV margin. No perioperative complications occurred, and the patient was discharged on POD 7.

Recognition of this rare variation in ICV preoperatively enabled safe and successful robot-assisted ileocecal resection with D3 lymph node dissection. No reports of a patient with a vascular anomaly similar to this case who underwent surgery were published.