Vascular anatomy of the right colon: A cadaveric study in a Vietnamese population with surgical implications

The right colon receives its blood supply from branches of the superior mesenteric artery (SMA), and its venous drainage converges on the superior mesenteric vein (SMV), in part via the gastrocolic trunk (Henle's trunk). Anatomical variations in these vessels are clinically significant during complete mesocolic excision (CME) with central vascular ligation (CVL) for right-sided colorectal cancer. Population-specific cadaveric data from Vietnam are lacking. A cross-sectional descriptive study was conducted on 31 embalmed adult Vietnamese cadavers (16 female, 15 male; mean age 75.4 ± 11.0 years) at the Department of Anatomy, University of Medicine and Pharmacy at Ho Chi Minh City, between April 2024 and May 2026. After standardized laparotomy, mesenteric dissection was performed from root to periphery. The SMA was left of the SMV in 96.8% of specimens; one variant (3.2%) showed right-of-SMV positioning. The ileocolic artery (ICA) was present in 100% of specimens and always originated from the SMA; 74.2% coursed posterior to the SMV and 25.8% anterior. The right colic artery (RCA) was absent in 35.5%, and when present originated from the SMA (55.0%), middle colic artery (MCA) (40.0%), or ICA (5.0%). The MCA was present in 100% of specimens; a dual-MCA variant was found in 6.5%. The ileocolic vein drained to the SMV in 100% of cases. The gastrocolic trunk (GCT) was present in 71.0% of specimens (absent in 29.0%), with a median length of 11.04 mm (IQR 10.40-12.74 mm). This study provides the first comprehensive cadaveric dataset of right colic vascular anatomy in Vietnamese subjects. Key findings - including the 35.5% absence rate of the RCA, 25.8% anterior ICA crossing, and 29.0% GCT absence - serve as direct intraoperative warning indicators for Vietnamese laparoscopic colorectal surgeons: approximately 1 in 4 patients will have the ICA crossing anterior to the SMV (mandating anterior-surface inspection before peritoneal incision), 1 in 3 will lack the RCA (precluding its use as a reliable landmark), and nearly 1 in 3 will have no GCT (requiring individual tributary ligation at the pancreatic head). These proportions constitute population-specific benchmarks that should inform preoperative planning and intraoperative decision-making during CME-CVL in this setting.