Anatomical characteristics and classifications of gastrocolic trunk of Henle in laparoscopic right colectomy: preliminary results of multicenter observational study

Abstract

Background

As a key landmark during laparoscopic right colectomy, the classification and variation of the gastrocolic trunk of Henle (GTH) remains to be clarified. The aim of this nationwide multicenter study was to describe the characteristics of the GTH intra-operatively during laparoscopic right colectomies.

Methods

Three hundred seventy-one patients who underwent laparoscopic right colectomies from January 2018 to March 2019 in 25 hospitals across China were enrolled in the study. The length of the GTH, the classification with a precise description of confluent tributaries, and other variations were analyzed.

Results

Of the 371 patients, 363 had a GTH. The proportion of type-0, type-I, type-II, and type-III was 15.2% (n = 55), 54.8% (n = 199), 25.3% (n = 92), and 4.7% (n = 17), respectively. The average length of the GTH was 8.5 mm, ranging from 2 to 30 mm.

Conclusions

This is the first multicenter study with a large sample by which the GTH was classified based on laparoscopic intraoperative observation. Variations in the GTH were classified into four types based on the number of colic drainage veins (right colic, superior right colic, middle colic, accessory middle colic, and ileocolic veins), among which the right colic vein was the most common. The length of the GTH was relatively short, and thus might carry a risk of bleeding. Further clinical data should be correlated with the characteristics of the GTH.

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Acknowledgements

Special thanks to the supports of the Chinese Society of Laparoscopic and Endoscopic Surgeons and the Chinese Society of Colorectal Surgeons to this study.

Funding

This work was supported by Shanghai Shen-kang Hospital Development Centre (16CR1011A), Shanghai Municipal Commission of Health and Family Planning Program (201640030), Shanghai Translational Medicine Collaborative Innovation Center Program (TM201701) and Natural Science Fund of Shanghai(18ZR1424100).

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Correspondence to Minhua Zheng or Bo Feng.

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Disclosures

Drs. Zirui He, Hao Su, Kai Ye, Yueming Sun, Yincong Guo, Quan Wang, Yong Li, Dechang Diao, Chunkang Yang, Nan Wang, Ang Li, WeiDong Tong, Peirong Ding, Yi Xiao, Xiaojun Zhou, Zhangfa Song, Su Yan, Hongwei Yao, Wenjian Meng, Donglei Zhou, Anlong Zhu, Yuan Gao, Hao Wang, Yiming Zhou, Xinxiang Li, Liang Kang, Minhua Zheng and Bo Feng have no conflict of interest or financial ties to disclose.

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He, Z., Su, H., Ye, K. et al. Anatomical characteristics and classifications of gastrocolic trunk of Henle in laparoscopic right colectomy: preliminary results of multicenter observational study. Surg Endosc 34, 4655–4661 (2020). https://doi.org/10.1007/s00464-019-07247-2

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Keywords

  • Gastrocolic trunk of Henle
  • Laparoscopic right colectomy
  • Classification
  • Anatomic variation