Department of Tumor Surgery, Second Affiliated Hospital of Fujian Medical University, Quanzhou, People's Republic of China.
World J Surg Oncol. 2019 Jan 12;17(1):16. doi: 10.1186/s12957-019-1561-4.
This study aimed to analyze right colonic vascular variability.
The study included 60 consecutive patients who underwent laparoscopic radical right colectomy and D3 lymph node dissection for malignant colonic cancer on the ileocecal valve, ascending colon or hepatic flexure (March 2013 to October 2016). The videos of the 60 surgical procedures were collected. Variations of right colonic vascular anatomy were retrospectively analyzed based on 60 high-resolution surgical videos of laparoscopic surgery.
The superior mesenteric artery and vein were present in all cases; 95.0% (57/60) had the superior mesenteric artery on the left side of the superior mesenteric vein. The ileocolic artery and vein occurred in 96.7% (58/60) and 100% (60/60) of cases, respectively; 50.0% (29/58) had the ileocolic artery passing the superior mesenteric vein anteriorly. Thirty-three (55.0%) cases had a right colic artery, and 2 (3.33%) had a double right colic artery; 90.9% (30/36) had the right colic vein passing anterior to the superior mesenteric artery. Fifty-six (93.3%) cases had a right colic vein; 7 (12.5%) had a right colic vein accompanied by a right colic artery, 66.1% (37/56) had the right colic vein draining into the gastrocolic trunk of Henle, 23.2% (13/56) had the right colic vein directly draining into superior mesenteric vein, and 10.7% (6/56) had one right colic vein draining into the superior mesenteric vein and the other into the gastrocolic trunk of Henle. Fifty-three (88.3%) cases had a gastrocolic trunk of Henle: a gastrocolic trunk in 35.8% (19/53), a gastropancreatic trunk in 9.4% (5/53), and a gastropancreaticocolic trunk in 54.7% (29/53). The frequencies of middle colic artery and vein were respectively 100% (60/60) and 93.3% (56/60).
Right colonic vascular variations were classified in Chinese patients. Notable findings included a superior mesenteric artery positioned to the right of the superior mesenteric vein and variation in middle colic artery length. This knowledge may be helpful to colorectal surgeons and could potentially help to improve safety by reducing vascular complications during minimally invasive procedures.
本研究旨在分析右结肠血管的变异性。
本研究纳入了 60 例连续接受腹腔镜右半结肠根治术和 D3 淋巴结清扫术的患者，这些患者的结肠癌位于回盲部、升结肠或肝曲（2013 年 3 月至 2016 年 10 月）。收集了 60 例手术的视频。回顾性分析了 60 例腹腔镜手术的高清手术视频，以了解右结肠血管解剖结构的变化。
肠系膜上动、静脉均存在于所有患者中；95.0%（57/60）的患者肠系膜上动位于肠系膜上静脉的左侧。回结肠动、静脉的发生率分别为 96.7%（58/60）和 100%（60/60）；50.0%（29/58）的患者回结肠动脉走行于肠系膜上静脉前方。33 例（55.0%）患者有右结肠动脉，2 例（3.33%）患者有双右结肠动脉；90.9%（30/36）的患者右结肠静脉位于肠系膜上动脉前方。56 例（93.3%）患者有右结肠静脉；7 例（12.5%）患者有右结肠伴右结肠动脉，66.1%（37/56）的患者右结肠静脉汇入Henle 胃结肠干，23.2%（13/56）的患者右结肠静脉直接汇入肠系膜上静脉，10.7%（6/56）的患者有 1 条右结肠静脉汇入肠系膜上静脉，另 1 条汇入 Henle 胃结肠干。53 例（88.3%）患者有 Henle 胃结肠干：胃结肠干 35.8%（19/53），胃胰干 9.4%（5/53），胃胰结肠干 54.7%（29/53）。中结肠动、静脉的发生率分别为 100%（60/60）和 93.3%（56/60）。
对中国患者的右结肠血管变异进行了分类。值得注意的发现包括肠系膜上动脉位于肠系膜上静脉的右侧和中结肠动脉长度的变化。这些知识可能对结直肠外科医生有帮助，并可能有助于通过减少微创过程中的血管并发症来提高安全性。
