Tajima Yusuke, Ishida Hideyuki, Ohsawa Tomonori, Kumamoto Kensuke, Ishibashi Keiichiro, Haga Norihiro, Osada Hisato
Department of Digest Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Int Surg. 2011 Oct-Dec;96(4):300-4. doi: 10.9738/cc20.1.
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.
我们分析了215例行右半结肠癌肿瘤切除手术患者的手术记录中有关右半结肠三维血管解剖的数据。146例患者(67.9%)无右结肠动脉(RCA),78例患者(36.3%)回结肠动脉(ICA)从腹侧跨过肠系膜上静脉(SMV)。当存在RCA时,44例患者(20.5%)的ICA和RCA均从腹侧跨过SMV,10例患者(4.7%)从背侧跨过,10例患者(4.7%)RCA从腹侧跨过SMV而ICA从背侧跨过,5例患者(2.2%)RCA从背侧跨过SMV而ICA从腹侧跨过。在151例符合条件的病例中,向肝曲走行的动脉分支从腹侧跨过SMV:97例患者(64.2%)分支起源于中结肠动脉的共同干,49例患者(32.5%)有1条动脉直接起源于肠系膜上动脉(SMA),5例患者(3.3%)有2条动脉直接起源于SMA。这些数据对于安全地进行SMV周围的淋巴结清扫将很有用。