Matthieu Bruzzi1,2,3,4, Leila M'harzi5,6,7, Tigran Poghosyan5,6,7, Iannis Ben Abdallah6, Argyri Papadimitriou5, Emilia Ragot5, Salma El Batti6, Vincent Balaya6, Julien Taieb6,8, Jean-Marc Chevallier5,6, Richard Douard5,6. 1. General and Digestive Surgery Unit, Georges Pompidou AP-HP University Hospital, 20, Rue Leblanc, 75908, Paris Cedex 15, France. matthieu.bruzzi@aphp.fr. 2. Paris Descartes Faculty of Medicine, Paris, France. matthieu.bruzzi@aphp.fr. 3. INSERM 970, Équipe 2, PARCC, HEGP, Paris, France. matthieu.bruzzi@aphp.fr. 4. Service de Chirurgie générale et digestive, Hôpital européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France. matthieu.bruzzi@aphp.fr. 5. General and Digestive Surgery Unit, Georges Pompidou AP-HP University Hospital, 20, Rue Leblanc, 75908, Paris Cedex 15, France. 6. Paris Descartes Faculty of Medicine, Paris, France. 7. INSERM 970, Équipe 2, PARCC, HEGP, Paris, France. 8. Digestive Oncology Unit, Georges Pompidou AP-HP University Hospital, Paris, France.
Abstract
PURPOSE: During right-sided colectomies, surgeons encounter major anatomical variations at the level of the right colon, leading to morbidity. Due to the confusion surrounding the colonic arterial vessels emerging from the superior mesenteric artery (SMA) to vascularize the right part of the colon, this review aimed to describe the arterial vessels found in the mesocolic structures of the ascending colon, the hepatic flexure and the right transverse colon. METHODS: A review of the literature was performed using the MEDLINE database. Only human studies were included. All dissection, angiographic, arterial cast and corrosion studies were analyzed. RESULTS: This review demonstrates that the right colon, the hepatic flexure and the right transverse colon are vascularized by three significant arteries emerging from the SMA and forming one peripheral paracolic arc: (1) the ileocolic artery (ICA), the most constant vessel (99.8%) with low variability; (2) the right colic artery (RCA), the most inconstant vessel (2/3 of cases) with high variability in its origin; and (3) the middle colic artery (MCA), a constant vessel (95%) with variation in its origin and its number. The marginal artery is almost constant (100%) and represents the only peripheral arterial arc at the level of the right side of the colon. CONCLUSIONS: Three arteries emerging from the superior mesenteric artery exist: the ICA, the RCA and the MCA. The ICA and the MCA are the most constant. Knowledge of this vascular anatomy is essential for performing right-sided colectomies.
PURPOSE: During right-sided colectomies, surgeons encounter major anatomical variations at the level of the right colon, leading to morbidity. Due to the confusion surrounding the colonic arterial vessels emerging from the superior mesenteric artery (SMA) to vascularize the right part of the colon, this review aimed to describe the arterial vessels found in the mesocolic structures of the ascending colon, the hepatic flexure and the right transverse colon. METHODS: A review of the literature was performed using the MEDLINE database. Only human studies were included. All dissection, angiographic, arterial cast and corrosion studies were analyzed. RESULTS: This review demonstrates that the right colon, the hepatic flexure and the right transverse colon are vascularized by three significant arteries emerging from the SMA and forming one peripheral paracolic arc: (1) the ileocolic artery (ICA), the most constant vessel (99.8%) with low variability; (2) the right colic artery (RCA), the most inconstant vessel (2/3 of cases) with high variability in its origin; and (3) the middle colic artery (MCA), a constant vessel (95%) with variation in its origin and its number. The marginal artery is almost constant (100%) and represents the only peripheral arterial arc at the level of the right side of the colon. CONCLUSIONS: Three arteries emerging from the superior mesenteric artery exist: the ICA, the RCA and the MCA. The ICA and the MCA are the most constant. Knowledge of this vascular anatomy is essential for performing right-sided colectomies.
Entities:
Keywords:
Cancer colon; Ileocolic artery; Middle colic artery; Right colic artery; Right-sided colectomy
Authors: Mehmet Ayhan Kuzu; Erkin İsmail; Safa Çelik; Muhammed Feyzi Şahin; Mehmet Ali Güner; Werner Hohenberger; Halil İbrahim Açar Journal: Dis Colon Rectum Date: 2017-03 Impact factor: 4.585