3D relations between right colon arteries and the superior mesenteric vein: a preliminary study with multidetector computed tomography

Spasojevic, Milan; Štimec, Bojan; Fasel, Jean; Terraz, Sylvain; Ignjatović, Dejan

doi:10.1007/s00464-010-1480-5

Cited by 50 publications

(44 citation statements)

References 12 publications

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“…Perhaps the discrepancy between our experience and that of Spasojevic et al [1] is partly a matter of definition. We and others have observed, for example, that the middle colic artery has many variations.…”

contrasting

confidence: 87%

“…As correctly observed by Spasojevic et al [1], the right mesocolon is not clearly defined at its medial aspect. When a complete mesocolic excision for right-sided colon cancer is performed, the fascia on both sides of the mesocolon, including the contained ileocolic artery (and the right colic artery when present) must be actively divided in a plane parallel to the mesenteric root.…”

supporting

confidence: 60%

“…We read with interest the report by Spasojevic et al [1] describing the origin of the right colic artery and the implications for oncologic resection of the ascending colon. Using computed tomographic (CT) angiography, the authors demonstrated a right colic artery arising from the superior mesenteric artery in 54% of patients, with this vessel passing posterior to the superior mesenteric vein in only 7.4% of cases.…”

mentioning

confidence: 99%

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Right hemicolectomy with central vascular ligation in colon cancer

Weber

Hohenberger

2011

Surg Endosc

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contrasting

confidence: 87%

supporting

confidence: 60%

mentioning

confidence: 99%

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Right hemicolectomy with central vascular ligation in colon cancer

Weber

Hohenberger

2011

Surg Endosc

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“…The ileocolic artery often passes posteriorly to the superior mesocolic vein [22][23][24], which theoretically should result in a longer residual stump as a central tie is more difficult to achieve and surgeons often choose to divide the vessel after the crossing of the vein. In our series, the ileocolic artery passed posterior to the superior mesocolic vein in 69% of cases but surprisingly did not result in a longer stump length probably because the superior mesocolic vein was never exposed.…”

Section: Discussionmentioning

confidence: 99%

Radiological and pathological evaluation of the level of arterial division after colon cancer surgery

et al. 2017

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There are no conflicts of interest Word count:Text: 2992 Abstract: 250Colon-CT study -3 - Abstract:Aim: Complete mesocolic excision for colon cancer includes central division of the tumour feeding artery. The degree of central radicality is assessed by measuring the distance from the tumour to the artery ligation by the pathologist on the resected specimen. As the length of the artery is highly variable between individuals, this technique may not be the most accurate measure of radicality as it cannot assess the length of the artery left behind inside the patient. The aim was to visualize the length of the tumour feeding artery after surgery and compare the relationship to pathological measures.Method: The length of the arterial stump was measured from the origin to the ligation point on a CT-scan two days post-operatively. This was done by a specialized radiologist who was blinded to operative procedure.Results: 52 patients had the required CT images. The mean length of the residual arterial stump was 38 mm, which was significantly longer than the expected length of <10 mm (p<0.0001). On the right side, the mean length was 31 mm and independent of the relation to the superior mesenteric vein. On the left side, the mean length was 49 mm. There was no correlation between the residual arterial stump and the pathological measures of specimen radicality.Conclusions: The residual arterial stumps measured by post-operative CT were longer than expected even on the right side where a CME was attempted.. Caution should be taken when using pathological measures as an estimation of a central ligation.Colon-CT study -4 -What does this paper add to the literature? This is the first study that measures the length of the remaining arterial stump after colon cancer surgery in a prospective and consecutive cohort. Furthermore, the results are compared to the pathological measures of central radicality on the specimen resected and we found no correlation.

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“…It is our opinion that the use of CT angiography with 3D reconstruction can facilitate the diagnosis, even more so, since it is noninvasive and can be derived from the same data set (CT). Data have also been provided showing that multidetector CT (MDCT) angiography can demonstrate 3D anatomical relationships of visceral vessels (15,16).…”

Section: Discussionmentioning

confidence: 99%