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 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 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.

Vascular Anatomy in Laparoscopic Colectomy for Right Colon Cancer

2016 ◽  
Vol 59 (8) ◽  
pp. 718-724 ◽  
Author(s):  
Sang Jae Lee ◽  
Sung Chan Park ◽  
Min Jung Kim ◽  
Dae Kyung Sohn ◽  
Jae Hwan Oh
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Colectomy ◽  
Vascular Anatomy ◽  
Right Colon ◽  
Right Colon Cancer

scholarly journals The right colic artery: An anatomical demonstration and its relevance in the laparoscopic era

2016 ◽  
Vol 98 (8) ◽  
pp. 560-563 ◽  
Author(s):  
M Haywood ◽  
C Molyneux ◽  
V Mahadevan ◽  
J Lloyd ◽  
N Srinivasaiah
Keyword(s):  
Complete Mesocolic Excision ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Right Colon ◽  
Early Evidence ◽  
Mesocolic Excision ◽  
Tissue Act ◽  
Human Tissue Act ◽  
The Right ◽  
Laparoscopic Techniques

INTRODUCTION Hemicolectomies are not tailored in right-sided colon cancer resections, despite significant variation in the incidence and origin of the right colic artery (RCA). Early evidence suggests that removal of the relevant lymphovascular package and associated cancer as part of complete mesocolic excision (CME), rather than the entire right colon, may produce better outcomes. Advancing laparoscopic techniques are making this possible, and so it is increasingly important to more precisely define the anatomy of the RCA. METHODS To demonstrate the incidence and variation of the RCA, 25 formalin embalmed cadavers were dissected. Consent to dissection and photography was obtained under Human Tissue Act regulations. RESULTS Eleven female and 14 male cadavers (mean age 79.7 years, range 41–95 years) were included. The RCA originated from the right branch of the middle colic artery in nine cadavers (36%), while it arose from the superior mesenteric artery in eight cases (32%) and from the ileocolic or root of the middle colic artery in a smaller number of specimens. The RCA was absent in two individuals. CONCLUSIONS The RCA arises from the right branch of the middle colic artery in a considerable number of cases. The literature to date does not reflect the precision of anatomical understanding required for CME; hence, a new definition for the right colic vessel is proposed.

scholarly journals Analysis on misdiagnosed cases of right colon cancer as appendicitis

2016 ◽  
Vol 2 (4) ◽  
pp. 201
Author(s):  
Sijia Liu
Keyword(s):  
Colon Cancer ◽  
Lower Abdomen ◽  
Appendiceal Abscess ◽  
Right Colon ◽  
Chronic Appendicitis ◽  
Right Colon Cancer ◽  
Colonic Lumen ◽  
Patient Prognosis ◽  
The Right ◽  
Improve Patient

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.

scholarly journals Systematic review of comparing single-incision versus conventional laparoscopic right hemicolectomy for right colon cancer

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Xin Liu ◽  
Wei-hong Yang ◽  
Zhou-guang Jiao ◽  
Ji-fu Zhang ◽  
Rui Zhang
Keyword(s):  
Colon Cancer ◽  
Meta Analysis ◽  
Right Hemicolectomy ◽  
Right Colon ◽  
Chi Square ◽  
Right Colon Cancer ◽  
Laparoscopic Right Hemicolectomy ◽  
Operation Duration ◽  
The Right

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.

A Shift to the Right: Colon Cancer 10 Years Later

2010 ◽  
Vol 105 ◽  
pp. S124-S125
Author(s):  
Matthew Shellenberger ◽  
Michael Komar ◽  
Zahoor Makhdoom
Keyword(s):  
Colon Cancer ◽  
Right Colon ◽  
Right Colon Cancer ◽  
The Right

scholarly journals Smoking-Related Risks of Colorectal Cancer by Anatomical Subsite and Sex

2020 ◽  
Vol 189 (6) ◽  
pp. 543-553 ◽  
Author(s):  
Inger T Gram ◽  
Song-Yi Park ◽  
Lynne R Wilkens ◽  
Christopher A Haiman ◽  
Loïc Le Marchand
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cox Regression ◽  
Left Colon ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Increased Risk ◽  
The Right ◽  
Incident Cases

Abstract The purpose of this study was to examine whether the increased risk of colorectal cancer due to cigarette smoking differed by anatomical subsite or sex. We analyzed data from 188,052 participants aged 45–75 years (45% men) who were enrolled in the Multiethnic Cohort Study in 1993–1996. During a mean follow-up period of 16.7 years, we identified 4,879 incident cases of invasive colorectal adenocarcinoma. In multivariate Cox regression models, as compared with never smokers of the same sex, male ever smokers had a 39% higher risk (hazard ratio (HR) = 1.39, 95% confidence interval (CI): 1.16, 1.67) of cancer of the left (distal or descending) colon but not of the right (proximal or ascending) colon (HR = 1.03, 95% CI: 0.89, 1.18), while female ever smokers had a 20% higher risk (HR = 1.20, 95% CI: 1.06, 1.36) of cancer of the right colon but not of the left colon (HR = 0.96, 95% CI: 0.80, 1.15). Compared with male smokers, female smokers had a greater increase in risk of rectal cancer with number of pack-years of smoking (P for heterogeneity = 0.03). Our results suggest that male smokers are at increased risk of left colon cancer and female smokers are at increased risk of right colon cancer. Our study also suggests that females who smoke may have a higher risk of rectal cancer due to smoking than their male counterparts.

Application of three-dimensional printing in laparoscopic dissection to facilitate D3-lymphadenectomy for right colon cancer

2018 ◽  
Vol 22 (2) ◽  
pp. 129-133 ◽  
Author(s):  
A. Garcia-Granero ◽  
L. Sánchez-Guillén ◽  
D. Fletcher-Sanfeliu ◽  
B. Flor-Lorente ◽  
M. Frasson ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Three Dimensional ◽  
Right Colon ◽  
D3 Lymphadenectomy ◽  
Three Dimensional Printing ◽  
Right Colon Cancer ◽  
Dimensional Printing
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