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Evaluation of the vascular anatomy of the right-sided colon using three-dimensional computed tomography angiography: a single-center study of 536 patients and a review of the literature

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The requisite for a rigorous preoperative understanding of vascular branching continues to grow in parallel with the implementation of laparoscopic surgery. Three-dimensional (3D)-computed tomography (CT) angiography is a less-invasive modality than traditional angiographic examination. Therefore, we aimed to evaluate branching patterns of the superior mesenteric artery (SMA).

Methods

In the present study, 536 consecutive patients who underwent preoperative 3D-CT angiography from April 2012 to March 2014 were prospectively enrolled. The branching pattern of the right colic artery (RCA) and the intersectional patterns of the RCA, ileocolic artery (ICA), and superior mesenteric vein (SMV) were evaluated.

Results

The RCA existed in only 179 cases (33.4 %); the remaining 357 patients (66.6 %) lacked evidence of the RCA. The ICA was detected in all cases. The RCA ran ventral to the SMV in the majority of cases (89.4 %). Conversely, the ICA ran ventral to the SMV in only half of the cases (50.6 %). When the RCA was observed to pass dorsal to the SMV, the ICA also ran dorsal to SMV in all cases.

Conclusions

3D-CT angiography can aid surgeons in identifying and understanding the anatomical vascular variations and intersectional patterns of the RCA, ICA, and SMV. Developing awareness of these variations can aid in the prevention of unexpected vascular injury during laparoscopic right-sided colon surgery.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Koji Murono, Kazushige Kawai, Soichiro Ishihara, Kensuke Otani, Koji Yasuda, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Hironori Yamaguchi & Toshiaki Watanabe

Authors
  1. Koji Murono
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  2. Kazushige Kawai
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  3. Soichiro Ishihara
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  4. Kensuke Otani
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  5. Koji Yasuda
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  6. Takeshi Nishikawa
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  7. Toshiaki Tanaka
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  8. Tomomichi Kiyomatsu
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  9. Keisuke Hata
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  10. Hiroaki Nozawa
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  11. Hironori Yamaguchi
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  12. Toshiaki Watanabe
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Correspondence to Koji Murono.

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Murono, K., Kawai, K., Ishihara, S. et al. Evaluation of the vascular anatomy of the right-sided colon using three-dimensional computed tomography angiography: a single-center study of 536 patients and a review of the literature. Int J Colorectal Dis 31, 1633–1638 (2016). https://doi.org/10.1007/s00384-016-2627-1

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  • DOI: https://doi.org/10.1007/s00384-016-2627-1

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