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

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.

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.


2004 ◽  
Vol 57 (2) ◽  
pp. 57-60
Author(s):  
T. Hirosawa ◽  
M. Itabashi ◽  
K. Yoshida ◽  
S. Ogawa ◽  
S. Kiyama ◽  
...  

2016 ◽  
Vol 59 (8) ◽  
pp. 718-724 ◽  
Author(s):  
Sang Jae Lee ◽  
Sung Chan Park ◽  
Min Jung Kim ◽  
Dae Kyung Sohn ◽  
Jae Hwan Oh

2018 ◽  
Vol 20 (10) ◽  
pp. 935-936 ◽  
Author(s):  
Á. García-Granero ◽  
L. Sánchez-Guillén ◽  
D. Fletcher-Sanfeliu ◽  
J. Sancho-Muriel ◽  
E. Alvarez-Sarrado ◽  
...  

2016 ◽  
Vol 2 (4) ◽  
pp. 201
Author(s):  
Sijia Liu

The aim of this case report is to investigate the causes of misdiagnosing right colon cancer as appendicitis, in order to reduce the misdiagnosis rate. The process of diagnosing and treating 44 misdiagnosed right colon cancer cases was analyzed. It was found that the right colonic lumen in these patients was thick, and their cancer consisted mostly of the ulcerative type or of a cauliflower-like tumor that protruded into the intestinal cavity. Moreover, ring-shaped and structured cancer was rarely observed, which suggested a decreased likelihood of obstruction. The patients showed limited peritoneal irritation signs in their right lower abdomen, which was also a potential cause for misdiagnosis. Right colon cancer associated with appendicitis is easily misdiagnosed as simple appendicitis, chronic appendicitis, or appendiceal abscess. Therefore, it is necessary to raise general awareness on the manifestations of the disease in order to exclude other common complications during diagnosis and to reduce the misdiagnosis rate. An accurate early diagnosis and treatment will improve patient prognosis.


2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Xin Liu ◽  
Wei-hong Yang ◽  
Zhou-guang Jiao ◽  
Ji-fu Zhang ◽  
Rui Zhang

Abstract Background Single-incision laparoscopic right hemicolectomy (SILS) has long used in surgery for a long time. However, there is barely a systemic review related to the comparison between the SILS and the conventional laparoscopic right hemicolectomy (CLS) for the right colon cancer in the long term follow-up. Herein, we used the most recent articles to compare these two techniques by meta-analysis. Methods We searched PubMed, Web of Science, Cochrane Library and Wanfang databases to compare SILS with CLS for right colon cancer up to May 2019. The operative, postoperative, pathological and mid-term follow-up outcomes of nine studies were extracted and compared. Results A total of 1356 patients participated in 9 studies, while 653 patients were assigned to the SILS group and 703 patients were assigned to the CLS group. The patients’ baselines in the SILS group were consistent with those in the CLS group. Compared to the CLS group, the SILS group had a shorter operation duration (SMD − 23.49, 95%CI − 36.71 to − 10.27, P < 0.001, chi-square = 24.11), shorter hospital stay (SMD − 0.76, 95% `CI − 1.07 to − 0.45, P < 0.001, chi-square = 9.85), less blood loss (SMD − 8.46, 95% CI − 14.59 to − 2.34; P < 0.05; chi-square = 2.26), smaller incision length (SMD − 1.60, 95% CI − 2.66 to − 0.55, P < 0.001; chi-square = 280.44), more lymph node harvested (SMD − 0.98, 95% CI − 1.79 to − 0.16, P < 0.05; chi-square = 4.61), and a longer proximal surgical edge (SMD − 0.51, 95% CI − 0.93 to − 0.09, P < 0.05; chi-square = 2.42). No significant difference was found in other indexes. After we removed a single large study, we performed another meta-analysis again. The operation duration in the SILS group was still better than that in the CLS group. Conclusion SILS could be a faster and more reliable approach than CLS for the right colon cancer and could accelerate patient recovery, especially for patients with a low BMI.


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