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Vascular anatomy of the splenic flexure: a review of the literature

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Abstract

Surgical treatment of the transverse colon is difficult because of the many variations of blood vessels. We reviewed the patterns of vascular anatomy and the definition of the vessels around the splenic flexure. We searched the PubMed database for studies on the vascular anatomy of the splenic flexure that were published from January 1990 to October 2020. After screening of full texts, 33 studies were selected. The middle colic arteries were reported to arise independently without forming a common trunk in 8.9–33.3% of cases. The left colic artery was absent in 0–7.5% of cases. The accessory middle colic artery was present in 6.7–48.9% of cases and was present in > 80% of cases without a left colic artery. The reported frequency of Riolan’s arch was 7.5–27.8%. The frequency was found to vary widely across studies, partially due to the ambiguous definition of Riolan’s arch. A comprehensive preoperative knowledge of the branching patterns of the middle colic artery and left colic artery and the presence of collateral arteries would be helpful in surgery for colon cancer in the splenic flexure.

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Acknowledgements

This research is supported by Grants-in-Aid for Scientific Research ( C : grant number; 18K07194 , C : grant number; 19K09115, and C : grant number; 20K21626) from Japan Society for the promotion of Science.

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Authors and Affiliations

  1. Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Koji Murono, Hiroaki Nozawa, Kazushige Kawai, Kazuhito Sasaki, Shigenobu Emoto, Junko Kishikawa, Hiroaki Ishii, Yuichiro Yokoyama, Shinya Abe, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda & Soichiro Ishihara

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  1. Koji Murono
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Murono, K., Nozawa, H., Kawai, K. et al. Vascular anatomy of the splenic flexure: a review of the literature. Surg Today 52, 727–735 (2022). https://doi.org/10.1007/s00595-021-02328-z

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