0 145

Cited 13 times in

Intraoperative Archive of Right Colonic Vascular Variability Aids Central Vascular Ligation and Redefines Gastrocolic Trunk of Henle Variants

Authors
 Jamal F. Alsabilah  ;  Syed A. Razvi  ;  Mahdi H. Albandar  ;  Nam K. Kim 
Citation
 DISEASES OF THE COLON & RECTUM, Vol.60(1) : 22-29, 2017 
Journal Title
 DISEASES OF THE COLON & RECTUM 
ISSN
 0012-3706 
Issue Date
2017
MeSH
Anatomic Variation* ; Cecal Neoplasms/surgery* ; Colectomy* ; Colon/blood supply ; Colon/surgery ; Colon, Ascending/blood supply* ; Colon, Ascending/surgery ; Colon, Transverse/blood supply* ; Colon, Transverse/surgery ; Colonic Neoplasms/surgery* ; Female ; Humans ; Intraoperative Period ; Laparoscopy ; Ligation ; Male ; Mesenteric Artery, Superior/anatomy & histology* ; Mesenteric Veins/anatomy & histology* ; Mesocolon/surgery* ; Middle Aged ; Prospective Studies
Abstract
BACKGROUND: Vascular supply to the right colon has become an issue because of high variability and subsequent impact on minimally invasive surgery. Past cadaveric or radiologic anatomic assessments are noncomprehensive. OBJECTIVE: Intraoperative charting of right colonic arteriovenous anatomy was undertaken to determine the incidence and scope of vascular variations. DESIGN: Vascular anatomy variations were documented in snapshot images, captured during laparoscopic video recordings or through open surgical digital photography. SETTINGS: Data were drawn from consecutive right hemicolectomies, routinely entailing complete mesocolic excision with central vascular ligation. PATIENTS: Seventy patients (mean age, 62.7 years; 37 women (52.8%); 33 men (47.2%)), each with surgically treatable right-sided colon cancer, were prospectively studied. RESULTS: Both ileocolic and middle colic arteries were regularly identified (100%), with right colic artery present in 41.4% of patients. Ileocolic and middle colic veins consistently drained into the right colon. Although the ileocolic vein always emptied into the superior mesenteric vein, drainage of the middle colic vein was split (superior mesenteric vein, 94.3%; gastrocolic trunk of Henle, 5.3%), as was drainage of the right colic (superior mesenteric vein, 43.3%; gastrocolic trunk of Henle, 56.7%) and accessory middle colic veins (superior mesenteric vein, 54.5%; gastrocolic trunk of Henle, 45.5%), present in 42.9% and 15.7% of patients. Gastrocolic trunk of Henle was found in 88.6% of patients, usually draining into the superior mesenteric vein. No significant sex-related differences were present regarding the incidence and scope of variability displayed by the right colic artery, right colic vein, accessory middle colic vein, or gastrocolic trunk of Henle classification (p > 0.05). LIMITATIONS: The inconsistency between cadaver and live surgery anatomy and the low BMI of the Asian population might be drawbacks of our study. CONCLUSIONS: Variations in right colonic arteriovenous channels, assessed intraoperatively, corroborate those established by cadaveric and radiologic means, prompting a new gastrocolic trunk of Henle classification.
Full Text
https://insights.ovid.com/pubmed?pmid=27926554
DOI
10.1097/DCR.0000000000000720
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165618
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links