Three-dimensional Computed Tomography for Analyzing the Vascular Anatomy in Laparoscopic Surgery for Right-sided Colon Cancer

2013 ◽  
Vol 23 (6) ◽  
pp. 536-539 ◽  
Author(s):  
Keitaro Hirai ◽  
Daisuke Yoshinari ◽  
Hiroomi Ogawa ◽  
Seshiru Nakazawa ◽  
Yoshiaki Takase ◽  
...  
2015 ◽  
Vol 100 (2) ◽  
pp. 208-212 ◽  
Author(s):  
Aya Kawamoto ◽  
Yasuhiro Inoue ◽  
Masato Okigami ◽  
Hiromi Yasuda ◽  
Yoshinaga Okugawa ◽  
...  

Although the safety of laparoscopic surgery for colon cancer has been reported in many randomized controlled trials, concerns about the difficulty of surgery for transverse colon cancer has not been fully resolved, mainly because of the variation in the vascular anatomy of mesenteric vessels, which leads to difficulty in determining the optimal operative procedure and the extent of lymph node dissection. We present the case of a patient with transverse colon cancer who underwent laparoscopic surgery after preoperative assessment using a combination of endoscopic clipping and three-dimensional computed tomography angiography (3DCTA). A 68-year-old man was diagnosed with transverse colon cancer, and laparoscopic surgery has been planned. 3DCTA showed right-middle and left-middle colic arteries arising independently from the superior mesenteric artery. The relationship between the clip and vessels showed that the right-middle colic artery was the feeding artery of the tumor. Operative findings were consistent with 3DCTA findings, and transverse colectomy with lymph node dissection was successfully performed.


2019 ◽  
Vol 103 (1-2) ◽  
pp. 15-20
Author(s):  
Tetsuo Ishizaki ◽  
Kenji Katsumata ◽  
Masayuki Hisada ◽  
Masanobu Enomoto ◽  
Takaaki Matsudo ◽  
...  

This study describes the efficacy of the evaluation of blood vessel anatomy by 3-dimensional computed tomography (3D-CT) for laparoscopic surgery for transverse colon cancer (TCC). A total of 102 patients with TCC were examined by preoperative 3D-CT to clarify their blood vessel anatomy at Tokyo Medical University Hospital between January 2010 and December 2015, before undergoing laparoscopic surgery using the obtained 3D-CT data. Regarding blood vessel variation, the middle colic artery (MCA) was present in all patients (100%). The common duct type was observed in 89 patients (87.3%), and a type of branch separate from the superior mesenteric artery was observed in 13 patients (12.7%). The accessory MCA was present in 25 patients (24.5%). The middle colic vein was present in all patients (100%), and it drained into the following vessels: the superior mesenteric vein, gastrocolic trunk, first jejunal vein, and inferior mesenteric vein [67 (65.8%), 25 (24.5%) 8 (7.8%), and 2 (1.9%) patients, respectively]. Regarding the surgical outcome, the bleeding volume was 43 g, the operative time was 218 minutes, the number of harvested lymph nodes was 21, the proximal resection margin was 164 mm, the distal resection margin was 105 mm, and the length of postoperative hospital stay was 10 days. Although complicated variations and anomalies in the MCA and the contiguous veins were observed, preoperative 3D-CT will be useful for surgeons performing laparoscopic surgery on patients with TCC.


2011 ◽  
Vol 96 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Yusuke Tajima ◽  
Hideyuki Ishida ◽  
Tomonori Ohsawa ◽  
Kensuke Kumamoto ◽  
Keiichiro Ishibashi ◽  
...  

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.


2013 ◽  
Vol 79 (5-6) ◽  
pp. 784-791 ◽  
Author(s):  
Cédric Barrey ◽  
Bogdan Ene ◽  
Guy Louis-Tisserand ◽  
Pietro Montagna ◽  
Gilles Perrin ◽  
...  

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