Mizumoto Rie, Tei Mitsuyoshi, Mori Soichiro, Nishida Kentaro, Yasuyama Akinobu, Nomura Masatoshi, Yoshikawa Yukihiro, Sueda Toshinori, Matsumura Tae, Koga Chikato, Miyagaki Hiromichi, Tsujie Masanori, Akamaru Yusuke
Department of Surgery, Osaka Rosai Hospital, 1179-3 Nagasonechō, Kita-ku, Sakai, Ōsaka-fu, 591-8025, Japan.
Surg Case Rep. 2022 Jun 6;8(1):110. doi: 10.1186/s40792-022-01462-1.
Numerous variations in vascular anatomy have been reported in the right colon. The ileocolic vein (ICV) generally drains directly into the superior mesenteric vein (SMV), and is an important landmark for laparoscopic surgery in right colon cancer. We present here a patient with a vascular anomaly of the ICV that was diagnosed on preoperative imaging.
A 65-year-old woman was diagnosed with transverse colon cancer by colonoscopy. Preoperative computed tomography scan showed that the ICV drained into the gastrocolic trunk of Henle (GCT) rather than the SMV. Single-incision laparoscopic transverse colectomy with D3 lymph node dissection was performed, dividing the middle colic vein (MCV) and preserving the right gastroepiploic vein (RGEV), anterior superior pancreaticoduodenal vein (ASPDV), GCT and ICV. The intraoperatively identified venous anatomy was consistent with the preoperative evaluation, and the RGEV, ASPDV and ICV were found to form the GCT.
We report a rare vascular anatomical anomaly that was diagnosed preoperatively, facilitating safe and successful single-incision laparoscopic surgery with D3 lymph node dissection.
右半结肠已报道有众多血管解剖变异。回结肠静脉（ICV）通常直接汇入肠系膜上静脉（SMV），是右半结肠癌腹腔镜手术的重要标志。我们在此报告一例术前影像学诊断为ICV血管异常的患者。
一名65岁女性经结肠镜检查诊断为横结肠癌。术前计算机断层扫描显示ICV汇入亨勒胃结肠干（GCT）而非SMV。行单孔腹腔镜横结肠切除术并D3淋巴结清扫，切断中结肠静脉（MCV）并保留右胃网膜静脉（RGEV）、胰十二指肠上前静脉（ASPDV）、GCT和ICV。术中确认的静脉解剖结构与术前评估一致，发现RGEV、ASPDV和ICV形成GCT。
我们报告了一例术前诊断的罕见血管解剖变异，这有助于安全成功地进行单孔腹腔镜D3淋巴结清扫手术。
