Vascular anatomy of the splenic flexure, focusing on the accessory middle colic artery and vein

2019 ◽  
Vol 22 (4) ◽  
pp. 392-398 ◽  
Author(s):  
K. Murono ◽  
H. Miyake ◽  
D. Hojo ◽  
H. Nozawa ◽  
K. Kawai ◽  
...  
Keyword(s):  
Splenic Flexure ◽  
Vascular Anatomy ◽  
Middle Colic Artery ◽  
Colic Artery

Surgical anatomy of the accessory middle colic artery: a meta‐analysis with implications for splenic flexure cancer surgery

2021 ◽  
Author(s):  
Isaac Cheruiyot ◽  
Roberto Cirocchi ◽  
Jeremiah Munguti ◽  
Justin Davies ◽  
Justus Randolph ◽  
...  
Keyword(s):  
Splenic Flexure ◽  
Meta Analysis ◽  
Surgical Anatomy ◽  
Cancer Surgery ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Splenic Flexure Cancer

scholarly journals Re-interpreting mesenteric vascular anatomy on 3D virtual and/or physical models: positioning the middle colic artery bifurcation and its relevance to surgeons operating colon cancer

2021 ◽  
Author(s):  
Bjarte T. Andersen ◽  
Bojan V. Stimec ◽  
Bjørn Edwin ◽  
Airazat M. Kazaryan ◽  
Przemyslaw J. Maziarz ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Splenic Vein ◽  
Vascular Anatomy ◽  
Middle Colic Artery ◽  
Inferior Mesenteric Vein ◽  
Anatomical Landmarks ◽  
Colic Artery ◽  
Mesenteric Vein ◽  
Wide Range ◽  
The Impact

Abstract Background The impact of the position of the middle colic artery (MCA) bifurcation and the trajectory of the accessory MCA (aMCA) on adequate lymphadenectomy when operating colon cancer have as of yet not been described and/or analysed in the literature. The aim of this study was to determine the MCA bifurcation position to anatomical landmarks and to assess the trajectory of aMCA. Methods The colonic vascular anatomy was manually reconstructed in 3D from high-resolution CT datasets using Osirix MD and 3-matic Medical and analysed. CT datasets were exported as STL files and supplemented with 3D printed models when required. Results Thirty-two datasets were analysed. The MCA bifurcation was left to the superior mesenteric vein (SMV) in 4 (12.1%), in front of SMV in 17 (53.1%) and right to SMV in 11 (34.4%) models. Median distances from the MCA origin to bifurcation were 3.21 (1.18–15.60) cm. A longer MCA bifurcated over or right to SMV, while a shorter bifurcated left to SMV (r = 0.457, p = 0.009). The main MCA direction was towards right in 19 (59.4%) models. When initial directions included left, the bifurcation occurred left to or anterior to SMV in all models. When the initial directions included right, the bifurcation occurred anterior or right to SMV in all models. The aMCA was found in 10 (31.3%) models, following the inferior mesenteric vein (IMV) in 5 near the lower pancreatic border. The IMV confluence was into SMV in 18 (56.3%), splenic vein in 11 (34.4%) and jejunal vein in 3 (9.4%) models. Conclusion Awareness of the wide range of MCA bifurcation positions reported is crucial for the quality of lymphadenectomy performed. The aMCA occurs in 31.3% models and its trajectory is in proximity to the lower pancreatic border in one half of models, indicating that it needs to be considered when operating splenic flexure cancer.

scholarly journals Three-Dimensional Vascular Anatomy Relevant to Oncologic Resection of Right Colon Cancer

2011 ◽  
Vol 96 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Yusuke Tajima ◽  
Hideyuki Ishida ◽  
Tomonori Ohsawa ◽  
Kensuke Kumamoto ◽  
Keiichiro Ishibashi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Three Dimensional ◽  
Vascular Anatomy ◽  
Middle Colic Artery ◽  
Common Trunk ◽  
Colic Artery ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Oncologic Resection ◽  
The Right

Abstract We analyzed data on the three-dimensional vascular anatomy of the right colon from the operative documents of 215 patients undergoing oncologic resection for right colon cancer. The right colic artery (RCA) was absent in 146 patients (67.9%), with the ileocolic artery (ICA) crossing the superior mesenteric vein (SMV) ventrally in 78 patients (36.3%). When the RCA was present, both the ICA and the RCA crossed the SMV ventrally in 44 patients (20.5%), dorsally in 10 patients (4.7%), the RCA crossed the SMV ventrally and the ICA dorsally in 10 patients (4.7%), and the RCA crossed the SMV dorsally and the ICA ventrally in 5 patients (2.2%). The arterial branches toward the hepatic flexure crossed the SMV ventrally in 151 eligible cases: the branch originated from the common trunk of the middle colic artery in 97 patients (64.2%) and 1 and 2 arteries directly originated from the SMA in 49 patients (32.5%) and in 5 patients (3.3%), respectively. These data would be useful to safely perform lymph node dissection around the SMV.

Evaluation of the vascular anatomy of the left-sided colon focused on the accessory middle colic artery: a single-centre study of 734 patients

2018 ◽  
Vol 20 (11) ◽  
pp. 1041-1046 ◽  
Author(s):  
H. Miyake ◽  
K. Murono ◽  
K. Kawai ◽  
K. Hata ◽  
T. Tanaka ◽  
...  
Keyword(s):  
Vascular Anatomy ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Single Centre ◽  
Centre Study ◽  
Single Centre Study

scholarly journals Colonic (splenic flexure) necrosis due to thrombosis of the middle colic artery following blunt abdominal trauma

1994 ◽  
Vol 112 (3) ◽  
pp. 622-624 ◽  
Author(s):  
Raul Coimbra ◽  
José Ribeiro Aguiar ◽  
Samir Rasslan ◽  
Silvio Pires Ressurreição
Keyword(s):  
Surgical Treatment ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Splenic Flexure ◽  
Unusual Case ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Colonic Necrosis ◽  
Non Surgical Treatment

We report an unusual case of a 28-year-old man who developed a colonic necrosis due to thrombosis of the middle colic artery 18 hours following blunt abdominal trauma. Although rare, this condition can occur in those patients whom non surgical treatment was initially performed.

scholarly journals Anatomske variacije vej, ki izhajajo iz zgornje mezenterične arterije

2018 ◽  
Vol 86 (9-11) ◽  
Author(s):  
Lidija Kocbek ◽  
Mateja Zemljič
Keyword(s):  
Small Intestine ◽  
Superior Mesenteric Artery ◽  
Blood Supply ◽  
Large Intestine ◽  
Abdominal Aorta ◽  
Transverse Colon ◽  
Mesenteric Artery ◽  
Vascular Anatomy ◽  
Middle Colic Artery ◽  
Colic Artery

Superior mesenteric artery, the second ventral branch of the abdominal aorta, supplies the distal duodenum, the small intestine, and the large intestine to the mid transverse colon. Superior mesenteric artery branches include the inferior anterior and inferior posterior pancreaticoduodenal arteries, middle colic artery, right colic artery, ileocolic artery, jejunal and ileal branches. The vascular anatomy of superior mesenteric branches is frequently variant. The explanation of variant vascular anatomy of branches and pathological consequences of diseases which impact the mesenteric vasculature might be due to the changes that appear in the development of ventral splanchnic arteries and their blood supply. Knowledge of mesenterical variations is valuable to radiologists and surgeons.

scholarly journals Splenic flexure cancer optimum level of vessel ligation

2017 ◽  
Vol 4 (4) ◽  
pp. 1355 ◽  
Author(s):  
T. Uma Maheswara Rao ◽  
Boddu Sankar Reddy ◽  
Supriya Chilukoti
Keyword(s):  
Cell Differentiation ◽  
Splenic Flexure ◽  
Tumor Grade ◽  
Middle Colic Artery ◽  
Distal Margin ◽  
Optimum Level ◽  
Colic Artery ◽  
Group A ◽  
Group B ◽  
Vessel Ligation

Background: Incidence of splenic flexure carcinoma is very low in colorectal cancer but often time presented in an advanced stage with high risk of obstruction, contributing poor prognosis. Aim of the study was to investigate the adequacy of vessel ligation in SFC in term of overall survival.Methods: 35 patients diagnosed with splenic flexure carcinoma enrolled and analyzed, patients categorized based on the level of vessel ligation as group-A, left branch of middle colic (LMA) and left colic artery division (LCA) compared, group-B, LCA and marginal of middle colic artery (MMC).Results: CEA marker was not significantly changed post-operatively, as it was within normal range preoperatively at an average of 9-12 µg/ml. There is no significance in staging of tumors in all stages, and recurrence of tumor is present in 5 in group A. Radical margins both proximal and distal ends are not significant. Tumor clearance achieved successfully in both arms in term of proximal margin achieved at 7.9±3.5cm in groups B and 8.3±4.1 cm in group A, p = 0.312. Distal margin reported at 8.7±4.1 cm and 8.9±3.98cm, p = 0.58, respectively. Lymph nodes are positive in group-A and group-B without any significance. Tumor size or diameter ranging from 5.1±3.1 in group-A and 4.76±3.8 in group-B. According to the cell differentiation, majority of the tumor grade turned out to be moderately differentiated cancer, rated at 14 patients (40.1%) in group A and 13 patients (37.1%) in group B. one patients found to be well or poorly differentiated cell tumors in group-A. Overall p-values were insignificant in regards tumor cell differentiation in both groups, p = 0.213. Incidence of lympho-vascular invasion reached only 3 (8.5%) vs. 4 patients (11.2%), p = 0.562, in A and B group.Conclusions: Higher level of vessel ligation has no added significance in overall outcome, but has role to lower the risk of recurrence rate in Splenic flexure carcinoma patients.

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