Preoperative MSCTA for navigation of laparoscopic right colon cancer CME surgery

Abstract

Objective To evaluate preoperative multislice CT angiography (MSCTA) in guidance for laparoscopic right colon cancer the complete mesocolon resection (CME). Methods From September 2014 to May 2016 data of 24 patients undergoing laparoscopic CME right colon cancer surgery, were reviewed for the guidance of MSCTA over operative surgery. Results Preoperative MSCTA clearly showed superior mesenteric vascular anatomical variation and its branch, which was in closely consistent with that seen during the operation. The superior mesenteric arteries and veins (SMA/SMV) and the ileum colon arteries and veins (ICA/ICV) were seen in all the 24 cases. There are four main types anatomic variation of gastrocolic trunk (Henle trunk), of which most often consisting of three branchs (type B), accounting for about 46%. The time of completely dissecting anatomical Henle trunk was significantly longer than that for the ileum colon vessels and the middle vessels dissection (P<0.05). Conclusion Preoperative MSCTA can clearly present anatomic variation of SMV/SMA and its branch, precisely navigate the laparoscopic right colon cancer CME surgery, reducing the incidence of intraoperative vascular complications and improving the quality of surgery. Key words: Colonic neoplasms; Mesocolon; Tomography, spiral computed