scholarly journals Re-interpreting mesenteric vascular anatomy on 3D virtual and/or physical models: positioning the middle colic artery bifurcation and its relevance to surgeons operating colon cancer

2021 ◽  
Author(s):  
Bjarte T. Andersen ◽  
Bojan V. Stimec ◽  
Bjørn Edwin ◽  
Airazat M. Kazaryan ◽  
Przemyslaw J. Maziarz ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Splenic Vein ◽  
Vascular Anatomy ◽  
Middle Colic Artery ◽  
Inferior Mesenteric Vein ◽  
Anatomical Landmarks ◽  
Colic Artery ◽  
Mesenteric Vein ◽  
Wide Range ◽  
The Impact

Abstract Background The impact of the position of the middle colic artery (MCA) bifurcation and the trajectory of the accessory MCA (aMCA) on adequate lymphadenectomy when operating colon cancer have as of yet not been described and/or analysed in the literature. The aim of this study was to determine the MCA bifurcation position to anatomical landmarks and to assess the trajectory of aMCA. Methods The colonic vascular anatomy was manually reconstructed in 3D from high-resolution CT datasets using Osirix MD and 3-matic Medical and analysed. CT datasets were exported as STL files and supplemented with 3D printed models when required. Results Thirty-two datasets were analysed. The MCA bifurcation was left to the superior mesenteric vein (SMV) in 4 (12.1%), in front of SMV in 17 (53.1%) and right to SMV in 11 (34.4%) models. Median distances from the MCA origin to bifurcation were 3.21 (1.18–15.60) cm. A longer MCA bifurcated over or right to SMV, while a shorter bifurcated left to SMV (r = 0.457, p = 0.009). The main MCA direction was towards right in 19 (59.4%) models. When initial directions included left, the bifurcation occurred left to or anterior to SMV in all models. When the initial directions included right, the bifurcation occurred anterior or right to SMV in all models. The aMCA was found in 10 (31.3%) models, following the inferior mesenteric vein (IMV) in 5 near the lower pancreatic border. The IMV confluence was into SMV in 18 (56.3%), splenic vein in 11 (34.4%) and jejunal vein in 3 (9.4%) models. Conclusion Awareness of the wide range of MCA bifurcation positions reported is crucial for the quality of lymphadenectomy performed. The aMCA occurs in 31.3% models and its trajectory is in proximity to the lower pancreatic border in one half of models, indicating that it needs to be considered when operating splenic flexure cancer.

scholarly journals Three-Dimensional Vascular Anatomy Relevant to Oncologic Resection of Right Colon Cancer

2011 ◽  
Vol 96 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Yusuke Tajima ◽  
Hideyuki Ishida ◽  
Tomonori Ohsawa ◽  
Kensuke Kumamoto ◽  
Keiichiro Ishibashi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Three Dimensional ◽  
Vascular Anatomy ◽  
Middle Colic Artery ◽  
Common Trunk ◽  
Colic Artery ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Oncologic Resection ◽  
The Right

Abstract We analyzed data on the three-dimensional vascular anatomy of the right colon from the operative documents of 215 patients undergoing oncologic resection for right colon cancer. The right colic artery (RCA) was absent in 146 patients (67.9%), with the ileocolic artery (ICA) crossing the superior mesenteric vein (SMV) ventrally in 78 patients (36.3%). When the RCA was present, both the ICA and the RCA crossed the SMV ventrally in 44 patients (20.5%), dorsally in 10 patients (4.7%), the RCA crossed the SMV ventrally and the ICA dorsally in 10 patients (4.7%), and the RCA crossed the SMV dorsally and the ICA ventrally in 5 patients (2.2%). The arterial branches toward the hepatic flexure crossed the SMV ventrally in 151 eligible cases: the branch originated from the common trunk of the middle colic artery in 97 patients (64.2%) and 1 and 2 arteries directly originated from the SMA in 49 patients (32.5%) and in 5 patients (3.3%), respectively. These data would be useful to safely perform lymph node dissection around the SMV.

scholarly journals A Case of Descending Colon Cancer with Tumor Thrombosis in the Inferior Mesenteric Vein

2019 ◽  
Vol 80 (4) ◽  
pp. 760-765
Author(s):  
Tetsuo TSUKAHARA ◽  
Eiji HAYASHI ◽  
Takeo KAWAHARA ◽  
Hiroki AOYAMA ◽  
Yukinori HATTORI ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Inferior Mesenteric Vein ◽  
Mesenteric Vein ◽  
Tumor Thrombosis ◽  
Descending Colon ◽  
Descending Colon Cancer

scholarly journals Vascular Structures of the Right Colon: Incidence and Variations with Their Clinical Implications

2016 ◽  
Vol 106 (2) ◽  
pp. 107-115 ◽  
Author(s):  
J. Alsabilah ◽  
W. R. Kim ◽  
N. K. Kim
Keyword(s):  
Colon Cancer ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Vascular Anatomy ◽  
Colic Artery ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Vascular Structures ◽  
Gastrocolic Trunk ◽  
The Right

Background and Aims: There is a demand for a better understanding of the vascular structures around the right colonic area. Although right hemicolectomy with the recent concept of meticulous lymph node dissection is a standardized procedure for malignant diseases among most surgeons, variations in the actual anatomical vascular are not well understood. The aim of the present review was to present a detailed overview of the vascular variation pertinent to the surgery for right colon cancer. Materials and Methods: Medical literature was searched for the articles highlighting the vascular variation relevant to the right colon cancer surgery. Results: Recently, there have been many detailed studies on applied surgical vascular anatomy based on cadaveric dissections, as well as radiological and intraoperative examinations to overcome misconceptions concerning the arterial supply and venous drainage to the right colon. Ileocolic artery and middle colic artery are consistently present in all patients arising from the superior mesenteric artery. Even though the ileocolic artery passes posterior to the superior mesenteric vein in most of the cases, in some cases courses anterior to the superior mesenteric artery. The right colic artery is inconsistently present ranging from 63% to 10% across different studies. Ileocolic vein and middle colic vein is always present, while the right colic vein is absent in 50% of patients. The gastrocolic trunk of Henle is present in 46%–100% patients across many studies with variation in the tributaries ranging from bipodal to tetrapodal. Commonly, it is found that the right colonic veins, including the right colic vein, middle colic vein, and superior right colic vein, share the confluence forming the gastrocolic trunk of Henle in a highly variable frequency and different forms. Conclusion: Understanding the incidence and variations of the vascular anatomy of right side colon is of crucial importance. Failure to recognize the variation during surgery can result in troublesome bleeding especially during minimal invasive surgery.

scholarly journals Rectal varices due to chronic inferior mesenteric vein thrombosis caused by external compression in a large hiatus hernia containing the pancreas

2018 ◽  
Vol 100 (7) ◽  
pp. e171-e173
Author(s):  
HA Rudman ◽  
MC Stott ◽  
MY Loh ◽  
EC Clark
Keyword(s):  
Hiatus Hernia ◽  
Splenic Vein ◽  
Inferior Mesenteric Vein ◽  
Retrograde Flow ◽  
Rectal Varices ◽  
External Compression ◽  
Mesenteric Vein ◽  
Vein Thrombosis ◽  
Type Iv ◽  
Large Hiatus Hernia

A 79-year-old woman presented with a large fresh rectal bleed. Computed tomography revealed that she had a large type IV hiatus hernia, which contained the stomach and pancreas. Compression of the inferior mesenteric vein and splenic vein had led to thrombosis within these vessels and retrograde flow within the inferior mesenteric vein. This had led to the formation of portosystemic rectal varices. Ectopic varices occasionally form in the rectum, often in the context of liver cirrhosis. At the time of writing, ours is the first reported case of portosystemic rectal varices formulated in response to obstruction of vessels within a hiatus hernia.

Optimal Management of the Splenic Vein at the Time of Venous Resection for Pancreatic Cancer: Importance of the Inferior Mesenteric Vein

2013 ◽  
Vol 18 (5) ◽  
pp. 917-921 ◽  
Author(s):  
Charles H. C. Pilgrim ◽  
Susan Tsai ◽  
Parag Tolat ◽  
Parag Patel ◽  
William Rilling ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Splenic Vein ◽  
Inferior Mesenteric Vein ◽  
Optimal Management ◽  
Venous Resection ◽  
Mesenteric Vein
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