Anatomical variations of the branches from left colic artery and middle colic artery at splenic flexure

Zou, Jiaxin; Jiang, Xiaofeng; Feng, Jubin; Cai, Jiawei; Kong, Decan; Cao, Wuteng; Zhao, Hengyu; Zhu, Dongyun; Meng, Xiaochun; Ke, Jia

doi:10.1007/s00276-022-02898-8

Cited by 3 publications

(4 citation statements)

References 12 publications

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“…There are many papers that have investigated the branching pattern of arteries in the splenic flexure [19][20][21][22][23][24][25][26][27][28][29], but none of them mentions the positional relationship with the veins as in this paper.…”

Section: Discussionmentioning

confidence: 99%

“…In past reports, AMCAs tend to be reported less frequently when investigated in cadavers or when the definition includes strict criteria for intra-abdominal running and branching positions ('running below the pancreas and toward the splenic flexure', 'arising separately from the SMA and more proximally than the first jejunal artery' etc.) [11,12,22,29,32]. Preoperative assessment of vascular anatomy using 3D CT angiography is useful in laparoscopic colorectal surgery [30,33,34].…”

Section: Discussionmentioning

confidence: 99%

“…There are many papers that have investigated the branching pattern of arteries in the splenic flexure [19–29], but none of them mentions the positional relationship with the veins as in this paper. The various patterns of venous drainage in the splenic flexure are due to the embryological process [16, 17, 30].…”

Section: Discussionmentioning

confidence: 99%

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Drainage pattern of the splenic flexure vein and its accompanying arteries using three‐dimensional computed tomography angiography: a single‐centre study of 600 patients

et al. 2023

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AimThe splenic flexure has variable vascular anatomy, and the details of the venous forms are not known. In this study, we report the flow pattern of the splenic flexure vein (SFV) and the positional relationship between the SFV and arteries such as the accessory middle colic artery (AMCA).MethodsThis was a single‐centre study using preoperative enhanced CT colonography images of 600 colorectal surgery patients. CT images were reconstructed into 3D angiography. SFV was defined as a vein flowing centrally from the marginal vein of the splenic flexure visible on CT. AMCA was defined as the artery feeding the left side of the transverse colon, separate from the left branch of the middle colic artery.ResultsThe SFV returned to the inferior mesenteric vein (IMV) in 494 cases (82.3%), the superior mesenteric vein in 51 cases (8.5%) and the splenic vein in seven cases (1.2%). The AMCA was present in 244 cases (40.7%). The AMCA branched from the superior mesenteric artery or its branches in 227 cases (93.0% of cases with existing AMCA). In the 552 cases in which the SFV returned to the IMV, superior mesenteric vein or splenic vein, the left colic artery was the most frequent artery accompanying the SFV (42.2%), followed by the AMCA (38.1%) and the left branch of the middle colic artery (14.3%).ConclusionsThe most common flow pattern of the vein in the splenic flexure is from the SFV to IMV. The SFV is frequently accompanied by the left colic artery or AMCA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Drainage pattern of the splenic flexure vein and its accompanying arteries using three‐dimensional computed tomography angiography: a single‐centre study of 600 patients

et al. 2023

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“…Since anatomical variations of the vasculature at splenic exure by left colic artery (LCA) and middle colic artery (MCA) remain ambiguous [4], surgery for splenic exure cancers is one of the most challenging operations among other colorectal surgical procedures [5]. Splenic exure colon, located between the right and left colon, received a dual vascular supply of both superior mesenteric vessels and inferior mesenteric vessels.…”

Section: Introductionmentioning

confidence: 99%

Extended Procedure Has No Oncological Benefits over Segmental Resection in the Treatment of Non-metastatic Splenic Flexure Colon Cancer, a Population-Based Cohort Study

Wang

Zheng

Chen

et al. 2023

Preprint

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AIM: To compare the oncological survival outcome between extended resections and segmental resection for non-metastatic splenic flexure tumors. METHODS: A total of 10063 splenic flexure colon cancers patients who underwent extended resection (n=5546) or segmental resection (n=4517) from 2010 to 2018 were included from the Surveillance, Epidemiology, and End Results (SEER)-registered database. Survival rates were compared between groups. To reduce the inherent bias of retrospective studies, propensity score matching (PSM) analysis was performed. RESULTS: Patients from the extended resection group had higher pT stage, pN stage, larger tumor size, and higher rates of elevated CEA level, perineural invasion, and tumor deposits than those from the segmental resection group (each P<0.05). The 5-year CSS rate was slightly lower in extended resection patients than that in segmental resection patients (79.2% vs. 81.6%, P =0.002), while the 5-year OS were comparable between groups (66.2% vs. 66.9%, P =0.513). After the PSM performed, both the 5-year CSS and 5-year OS rates in extended resection group and segmental resection group were comparable (5-year CSS: 84.9% vs. 83.0%, P =0.577; 5-year OS: 70.6% vs. 66.0%, P =0.415). These findings were similar in the subgroup analysis that included only patients with stage III disease or with tumor size ≥ 7 cm. In addition, although the number of harvested lymph nodes was larger in the extended resection group compared to the segmental resection group (12.7 vs. 14.4, P<0.001), the numbers of invaded lymph nodes remained similar between groups (0.5 vs. 0.5, P=0.90). CONCLUSION: Extended procedures have no significant oncological benefits over segmental resection in the treatment of non-metastatic splenic flexure colon cancer, even for locally advanced cases. The larger number of harvested lymph nodes in the extended resection group did not confer any advantage relative to segmental resection with regard to CSS, since it was not associated with an increase in the number of invaded lymph nodes harvested.

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Extended procedure has no oncological benefits over segmental resection in the treatment of non-metastatic splenic flexure colon cancer, a population-based cohort study and a single center’s decade-long experience

Wang,

Zheng

et al. 2024

Updates Surg

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Anatomical variations of the branches from left colic artery and middle colic artery at splenic flexure

Cited by 3 publications

References 12 publications

Drainage pattern of the splenic flexure vein and its accompanying arteries using three‐dimensional computed tomography angiography: a single‐centre study of 600 patients

Drainage pattern of the splenic flexure vein and its accompanying arteries using three‐dimensional computed tomography angiography: a single‐centre study of 600 patients

Extended Procedure Has No Oncological Benefits over Segmental Resection in the Treatment of Non-metastatic Splenic Flexure Colon Cancer, a Population-Based Cohort Study

Extended procedure has no oncological benefits over segmental resection in the treatment of non-metastatic splenic flexure colon cancer, a population-based cohort study and a single center’s decade-long experience

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