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01-06-2014 | Colorectal Cancer

Preoperative Evaluation of Venous Anatomy in Laparoscopic Complete Mesocolic Excision for Right Colon Cancer

Authors: Takayuki Ogino, MD, Ichiro Takemasa, MD, PhD, Genki Horitsugi, Mamoru Furuyashiki, Katsuya Ohta, MD, Mamoru Uemura, MD, PhD, Junichi Nishimura, MD, PhD, Taishi Hata, MD, PhD, Tsunekazu Mizushima, MD, PhD, Hirofumi Yamamoto, MD, PhD, Yuichiro Doki, MD, PhD, Masaki Mori, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 3/2014

Abstract

Purpose

This study evaluated the venous variations of the right colon using preoperative three-dimensional computed tomography (3D-CT), and to investigate its usefulness in laparoscopic complete mesocolic excision (CME) for right colon cancer.

Methods

3D-CT was performed prior to surgery in 81 consecutive patients with right colon cancer.

Results

Laparoscopic right hemicolectomy was performed without conversion to open surgery in all cases (100 %). All 81 patients had a single ileocolic vein (ICV). The ICV flowed into the superior mesenteric vein (SMV) in 98 % of patients and the gastrocolic trunk (GCT) in 2 % of patients. The right colic vein (RCV) was absent in 6 % of patients. One RCV was present in 88 % of patients and two were present in 6 % of patients. The main RCV flowed into the GCT in 84 % of patients and the SMV in 10 % of patients. The superior RCV was present in 21 % of patients, and all cases flowed into the GCT. One middle colic vein (MCV) was present in 49 % of patients, two in 46 %, and three in 5 % of patients. The main MCV flowed into the SMV in 68 % of patients, GCT in 20 %, jejunal vein in 6 %, inferior mesenteric vein in 5 %, and the splenic vein in 1 % of patients. The GCT was present in 88 % of patients.

Conclusions

Although the venous tributaries of the right colon are variable, preoperative 3D-CT is informative and helpful for surgeons performing laparoscopic CME for right colon cancer.

The Colon Cancer Laparoscopic or Open Resection Study Group. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009;10(1):44–52.PubMedCrossRef

The Colon Cancer Laparoscopic or Open Resection Study Group. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477–484.PubMedCrossRef

The Clinical Outcomes of Surgical Therapy Study Groups. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350(20):2050–2059.CrossRef

Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359(9325):2224–2229.PubMedCrossRef

Hazebroek EJ, Color Study Group. COLOR: a randomized clinical trial comparing laparoscopic and open resection for colon cancer. Surg Endosc. 2002;16(6):949–953.PubMedCrossRef

West NP, Morris EJ, Rotimi O, Cairns A, Finan PJ, Quirke P. Pathology grading of colon cancer surgical resection and its association with survival: a retrospective observational study. Lancet Oncol. 2008;9(9):857–865.PubMedCrossRef

Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation: technical notes and outcome. Colorectal Dis. 2009;11(4):354–364; discussion 364-365.PubMedCrossRef

Yamaguchi S, Kuroyanagi H, Milsom JW, Sim R, Shimada H. Venous anatomy of the right colon: precise structure of the major veins and gastrocolic trunk in 58 cadavers. Dis Colon Rectum. 2002;45(10):1337–1340.PubMedCrossRef

Netter FH. Atlas of human anatomy. 4th ed. Philadelphia: Saunders; 2006.

10.

Matsuki M, Tanikake M, Kani H, et al. Dual-phase 3D CT angiography during a single breath-hold using 16-MDCT: assessment of vascular anatomy before laparoscopic gastrectomy. Am J Roentgenol. 2006;186(4):1079–1085.CrossRef

11.

McDaniel KP, Charnsangavej C, DuBrow RA, Varma DG, Granfield CA, Curley SA. Pathways of nodal metastasis in carcinomas of the cecum, ascending colon, and transverse colon: CT demonstration. Am J Roentgenol. 1993;161(1):61–64.CrossRef

12.

Ignjatovic D, Spasojevic M, Stimec B. Can the gastrocolic trunk of Henle serve as an anatomical landmark in laparoscopic right colectomy? A postmortem anatomical study. Am J Surg. 2010;199(2):249–254.PubMedCrossRef

13.

Jin G, Tuo H, Sugiyama M, et al. Anatomic study of the superior right colic vein: its relevance to pancreatic and colonic surgery. Am J Surg. 2006;191(1):100–103.PubMedCrossRef

14.

Sakaguchi T, Suzuki S, Morita Y, et al. Analysis of anatomic variants of mesenteric veins by 3-dimensional portography using multidetector-row computed tomography. Am J Surg. 2010;200(1):15–22.PubMedCrossRef

15.

Lange JF, Koppert S, van Eyck CH, Kazemier G, Kleinrensink GJ, Godschalk M. The gastrocolic trunk of Henle in pancreatic surgery: an anatomo-clinical study. J Hepatobiliary Pancreat Surg. 2000;7(4):401–403.PubMedCrossRef

16.

Ibukuro K,Tsukiyama T, Mori K, Inoue Y. Peripancreatic veins on thin-section (3 mm) helical CT. Am J Roentgenol. 1996;167(4):1003–1008.CrossRef

17.

Ito K, Blasbalg R, Hussain SM, Mitchell DG. Portal vein and its tributaries: evaluation with thin-section three-dimensional contrast-enhanced dynamic fat-suppressed MR imaging. Radiology. 2000;215(2):381–386.PubMedCrossRef

18.

Crabo LG, Conley DM, Graney DO, Freeny PC. Venous anatomy of the pancreatic head: normal CT appearance in cadavers and patients. Am J Roentgenol. 1993;160(5):1039–1045.CrossRef

19.

Zhang J, Rath AM, Boyer JC, Dumas JL, Menu Y, Chevrel JP. Radioanatomic study of the gastrocolic venous trunk. Surg Radiol Anat. 1994;16(4):413–418.PubMedCrossRef

20.

Toyota S, Ohta H, Anazawa S. Rationale for extent of lymph node dissection for right colon cancer. Dis Colon Rectum. 1995;38(7):705–711.PubMedCrossRef

21.

Marcello PW, Roberts PL, Rusin LC, Holubkov R, Schoetz DJ. Vascular pedicle ligation techniques during laparoscopic colectomy: a prospective randomized trial. Surg Endosc. 2006;20(2):263–269.PubMedCrossRef

Title: Preoperative Evaluation of Venous Anatomy in Laparoscopic Complete Mesocolic Excision for Right Colon Cancer
Authors: Takayuki Ogino, MD
Ichiro Takemasa, MD, PhD
Genki Horitsugi
Mamoru Furuyashiki
Katsuya Ohta, MD
Mamoru Uemura, MD, PhD
Junichi Nishimura, MD, PhD
Taishi Hata, MD, PhD
Tsunekazu Mizushima, MD, PhD
Hirofumi Yamamoto, MD, PhD
Yuichiro Doki, MD, PhD
Masaki Mori, MD, PhD
Publication date: 01-06-2014
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue Special Issue 3/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-3572-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Preoperative Evaluation of Venous Anatomy in Laparoscopic Complete Mesocolic Excision for Right Colon Cancer

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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