腹腔镜扩大右半结肠切除术治疗右半结肠癌并中央血管结扎时的血管变异情况

Vascular variants in laparoscopic extended right hemicolectomy with central vascular ligation for right colon cancer.

作者信息

Tei Mitsuyoshi, Suzuki Yozo, Ohtsuka Masahisa, Yoshikawa Yukihiro, Sueda Toshinori, Imasato Mitsunobu, Hasegawa Junichi, Akamatsu Hiroki

机构信息

Department of Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kita-ku, Sakai, 591-8025, Japan.

Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan.

出版信息

Surg Today. 2022 Oct;52(10):1414-1422. doi: 10.1007/s00595-022-02511-w. Epub 2022 May 10.

DOI:10.1007/s00595-022-02511-w

PMID:35536401

Abstract

PURPOSE

To evaluate the right colic vascularity, focusing on the confluences of veins.

METHODS

The subjects of this retrospective study were 100 patients who underwent laparoscopic extended right hemicolectomy (Lap-ERHC) between April 2015 and September 2020, at our hospitals. Veins draining into the superior mesenteric vein (SMV) included the ileocecal vein (ICV), the right colic vein (RCV), the middle colic vein (MCV), and the gastrocolic trunk of Henle (GCT). Veins draining into vessels other than the SMV were defined as accessory colic veins (aICV, aRCV or aMCV).

RESULTS

The GCT, aRCV, and aMCV were found in 86, 89, and 15 patients, respectively. In 66 patients with one aRCV, drainage was split as the anterior superior pancreaticoduodenal vein (ASPDV) in 12, the right gastroepiploic vein (RGEV) in 7, and the GCT in 47. In 23 patients with two aRCVs, drainage was split as the ASPDV in 4, the RGEV in 1, the GCT in 11, and the ASPDV and GCT in 7. In 14 patients with one aMCV, drainage was split as the GCT in 8, the splenic vein in 5, and the first jejunal vein (FJV) in 1. One patient had two aMCVs, draining into the GCT and the FJV.

CONCLUSIONS

The findings of our evaluation of vascular anatomy, focusing on confluences of the colic veins, provides useful information for colorectal surgeons.

摘要

目的

评估右结肠血管情况，重点关注静脉汇合处。

方法

本回顾性研究的对象为2015年4月至2020年9月期间在我院接受腹腔镜扩大右半结肠切除术（Lap-ERHC）的100例患者。汇入肠系膜上静脉（SMV）的静脉包括回结肠静脉（ICV）、右结肠静脉（RCV）、中结肠静脉（MCV）和亨氏胃结肠干（GCT）。汇入SMV以外血管的静脉被定义为副结肠静脉（aICV、aRCV或aMCV）。

结果

分别在86例、89例和15例患者中发现了GCT、aRCV和aMCV。在66例有1条aRCV的患者中，分流情况如下：12例汇入胰十二指肠上前静脉（ASPDV），7例汇入右胃网膜静脉（RGEV），47例汇入GCT。在23例有2条aRCV的患者中，分流情况如下：4例汇入ASPDV，1例汇入RGEV，11例汇入GCT，7例汇入ASPDV和GCT。在14例有1条aMCV的患者中，分流情况如下：8例汇入GCT，5例汇入脾静脉，1例汇入第一空肠静脉（FJV）。1例患者有2条aMCV，分别汇入GCT和FJV。