Department of Gastrointestinal Surgical Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, 420 Fuma Street, Jinan, Fuzhou, Fujian, 350014, P.R. China.
World J Surg Oncol. 2021 Jun 28;19(1):189. doi: 10.1186/s12957-021-02307-1.
Understanding the vascular anatomy is critical for performing central vascular ligation (CVL) in right hemicolectomy with complete mesocolic excision (CME). This study aimed to investigate the predictive value of multi-slice spiral computed tomography (MSCT) with coronal reconstruction in right hemicolectomy with CME.
This is a retrospective descriptive study. Eighty patients with right colon cancer who underwent right hemicolectomy from December 2015 to January 2020 were included. The intraoperative reports (including imaging data) and MSCT images with coronal reconstruction were analysed and compared. The detection rates of the ileocolic vein (ICV) and ileocolic artery (ICA) roots and the accuracy in predicting their anatomical relationship were analysed. The detection rate and accuracy in predicting the location of the gastrocolic trunk of Henle (GTH), middle colic artery (MCA) and middle colic vein (MCV) were analysed. The distance from the ICV root to the GTH root (ICV-GTH distance) was measured and analysed. The maximum distance from the left side of the superior mesenteric artery (SMA) to the right side of the superior mesenteric vein (SMV), named the 'lsSMA-rsSMV distance', was also measured and analysed.
In seventy-four (92.5%) patients, both the ICV and ICA roots were located; their anatomical relationship was determined by MSCT, and the accuracy of the prediction was 97.2% (72/74). The GTH was located by MSCT in 75 (93.7%) patients, and the accuracy of the prediction was 97.33% (73/75). The MCA was located by MSCT in 47 (58.75%) patients, and the accuracy was 78.72% (37/47). The MCV was located by MSCT in 51 (63.75%) patients, and the accuracy of the prediction was 84.31% (43/51). The ICV-GTH distance was measured in 73 (91.2%) patients, and the mean distance was 4.28 ± 2.5 cm. The lsSMA-rsSMV distance was measured in 76 (95%) patients, and the mean distance was 2.21 ± 0.6 cm.
With its satisfactory accuracy in predicting and visualising the information of key anatomical sites, MSCT with coronary reconstruction has some predictive value in CME with CVL in right hemicolectomy.
理解血管解剖结构对于在右半结肠切除术（右半结肠切除术）中进行中央血管结扎（CVL）至关重要。本研究旨在探讨多层螺旋 CT（MSCT）冠状重建在右半结肠切除术伴完全结肠系膜切除（CME）中的预测价值。
这是一项回顾性描述性研究。纳入 2015 年 12 月至 2020 年 1 月期间接受右半结肠切除术的 80 例右结肠癌患者。分析比较了术中报告（包括影像学数据）和 MSCT 冠状重建图像。分析了回结肠静脉（ICV）和回结肠动脉（ICA）根部的检出率及其预测解剖关系的准确性。分析了胃结肠干（GTH）、中结肠动脉（MCA）和中结肠静脉（MCV）的位置预测的检出率和准确性。测量并分析了 ICV 根部至 GTH 根部的距离（ICV-GTH 距离）。还测量并分析了肠系膜上动脉（SMA）左侧至肠系膜上静脉（SMV）右侧的最大距离，命名为“lsSMA-rsSMV 距离”。
在 74 例（92.5%）患者中，均定位了 ICV 和 ICA 根部；通过 MSCT 确定了它们的解剖关系，预测的准确性为 97.2%（72/74）。75 例（93.7%）患者通过 MSCT 定位了 GTH，预测的准确性为 97.33%（73/75）。47 例（58.75%）患者通过 MSCT 定位了 MCA，准确性为 78.72%（37/47）。51 例（63.75%）患者通过 MSCT 定位了 MCV，预测的准确性为 84.31%（43/51）。73 例（91.2%）患者测量了 ICV-GTH 距离，平均距离为 4.28±2.5cm。76 例（95%）患者测量了 lsSMA-rsSMV 距离，平均距离为 2.21±0.6cm。
MSCT 冠状重建在预测和可视化关键解剖部位信息方面具有令人满意的准确性，在右半结肠切除术伴 CVL 的 CME 中具有一定的预测价值。
