Clinical outcomes and radiological assessment of vascular anatomy in patients who underwent D3 left hemicolectomy
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background.Adequate blood supply is one of the key factors for colorectal anastomosis healing.Various variants of vascular anatomy often come as a surprise to surgeons during operations.Objectives.The aims of this study were to carry out a comparative analysis of three-dimensional-computed tomography (3D-CT) angiography data with intraoperative data and a detailed analysis of variants of the anatomy of splenic flexure.Material and methods.In this study, we included 103 patients (56 males and 47 females; mean age 64.2 ± 11.6) with the left-sided colon and rectal cancer who underwent preoperative 3D-CT angiography at Ternopil University Hospital between 2016 and 2022.Results.According to the recently proposed classification, there are four types of blood supply to the splenic flexure of the colon: Our analysis showed that type 1 was found in 83 (80.6%) patients, type 2 in 9 (8.7%), type 3 in 10 (9.7%), and type 4 in 1 (1%).All patients underwent local left radical hemicolectomy with resection of complete mesocolic excision (CME), central vascular ligation (CVL) and resección (R0).Seven cases were operated laparoscopically; and the median quantity of removal lymph nodes was 21.54 ± 7.32.Positive lymph nodes were revealed in 24.3% cases.AL was diagnosed in one patient.Conclusions.Careful pre-operative analysis of vascular anatomy on 3D-CT angiography will assess the vascularization of the splenic flexure of the colon, reduce intraoperative time to identify structures, and develop a personalized strategy for surgery which potentially can reduce the risk of anastomotic leakage.
Institution: I.Horbachevsky Ternopil National Medical University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4404130217