Three-dimensional computed tomographic angiography with computed tomographic colonography for laparoscopic colorectal surgery

Hiroishi, Atsushi; Yamada, Takayuki; Morimoto, Takahiro; Horikoshi, Kuniyasu; Nakajima, Yasuo

doi:10.1007/s11604-018-0775-7

Cited by 18 publications

(24 citation statements)

References 25 publications

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“…In order to present the SMA and SMV arborization, one can apply the fused 3D image of the colon map, arteriography and venography [22], or digital subtraction angiography [23]. We have chosen segmentation and 3D reconstruction based on one acquisition, as this image can easily be zoomed and observed from any angle, an option particularly appreciated when performing laparoscopic or robotic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Except for the exceptionally rare cases of ileocaecal region agenesis [24], the ileocolic vessels seem to be almost invariably present [10,13,16,22]. Of course, the definition of a colic vessel comes into perspective here; for instance, a right colic artery (RCA) can be defined as an independent branch of the SMA, a side branch of the ICA or MCA, or both [11,13,22,25]. What adds to the confusion with nomenclature are the novel proposals in which the terminal SMA is classified as the ICA, and the ‘former’ ICA now becomes the RCA [26].…”

Section: Discussionmentioning

confidence: 99%

“…One of the common arterial colic trunks crossed the SMV anteriorly, and the other posteriorly. As for the ICA, the posterior crossing, which is more difficult to handle practically, is found in 28%–62% of cases [10–12,16,22]. It is worth noting that the colic artery crossing pattern is independent of the ICV–GTH distance [16].…”

Section: Discussionmentioning

confidence: 99%

“…ª 2020 The Association of Coloproctology of Great Britain and Ireland. 22,[1949][1950][1951][1952][1953][1954][1955][1956][1957]…”

Section: Conflicts Of Interestmentioning

confidence: 99%

“…A formol-fixed dissection specimen. Arrows, ileocolic fold; TMC, transverse mesocolon; Mes, small bowel mesentery.ª 2020 The Association of Coloproctology of Great Britain and Ireland 22,…”

mentioning

confidence: 99%

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Navigating the mesentery: Part III. Unusual anatomy of ileocolic vessels

Štimec

Ignjatović

2020

Colorectal Disease

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Aim The ileocolic vessels are important landmarks in advanced surgery of the midgut. The aim of the present study is to present variations of ileocolic vessels relevant to complete mesocolic excision with D3 lymphadenectomy of the right colon, within their detailed and precise morphometric framework and deriving from a large and consistent series of operated patients. Methods An ongoing prospective trial 'Safe Radical D3 Right Hemicolectomy for Cancer through Preoperative Biphasic Multidetector Computed Tomography Angiography' was reviewed. The imaging datasets underwent manual segmentation and 3D reconstruction, and the results were validated at surgery. A total of 356 patients were included in the study. Results A cross-section of the series revealed five cases (1.4%) with variation of ileocolic vessels relevant to complete mesocolic excision or D3 extended mesenterectomy. There were two cases with absence of a true classical ileocolic artery, two cases with absence of a true classical ileocolic vein, and one case of precocious bifurcation of the ileocolic artery, left to the superior mesenteric vein. The entire D3 area in all the cases was thoroughly documented and analysed from the morphometric point of view (calibres, lengths of vessels, crossing patterns). Conclusion The preoperative visualization of a patient's individual 3D anatomy is a powerful tool in identifying the variations whose negligence could have dire consequences in complete mesocolic excision of the right colon.

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Section: Discussionmentioning

confidence: 99%