Preoperative Evaluation of Venous Anatomy in Laparoscopic Complete Mesocolic Excision for Right Colon Cancer
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This study evaluated the venous variations of the right colon using preoperative three-dimensional computed tomography (3D-CT), and to investigate its usefulness in laparoscopic complete mesocolic excision (CME) for right colon cancer.
3D-CT was performed prior to surgery in 81 consecutive patients with right colon cancer.
Laparoscopic right hemicolectomy was performed without conversion to open surgery in all cases (100 %). All 81 patients had a single ileocolic vein (ICV). The ICV flowed into the superior mesenteric vein (SMV) in 98 % of patients and the gastrocolic trunk (GCT) in 2 % of patients. The right colic vein (RCV) was absent in 6 % of patients. One RCV was present in 88 % of patients and two were present in 6 % of patients. The main RCV flowed into the GCT in 84 % of patients and the SMV in 10 % of patients. The superior RCV was present in 21 % of patients, and all cases flowed into the GCT. One middle colic vein (MCV) was present in 49 % of patients, two in 46 %, and three in 5 % of patients. The main MCV flowed into the SMV in 68 % of patients, GCT in 20 %, jejunal vein in 6 %, inferior mesenteric vein in 5 %, and the splenic vein in 1 % of patients. The GCT was present in 88 % of patients.
Although the venous tributaries of the right colon are variable, preoperative 3D-CT is informative and helpful for surgeons performing laparoscopic CME for right colon cancer.
KeywordsSuperior Mesenteric Vein Hepatic Flexure Common Trunk Inferior Mesenteric Vein Marginal Vein
Conflicts of interest
Takayuki Ogino, Ichiro Takemasa, Genki Horitsugi, Mamoru Furuyashiki, Katsuya Ohta, Mamoru Uemura, Junichi Nishimura, Taishi Hata, Tsunekazu Mizushima, Hirofumi Yamamoto, Yuichiro Doki, and Masaki Mori have no conflicts of interest or financial ties to disclose.
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