ArticleAnnals of gastroenterological surgery2026
Preoperative Computed Tomography Colonography-Angiography for Vascular Mapping to Guide and Standardize D3 Lymphadenectomy in Right-Sided and Transverse Colon Cancer.
Article in Annals of gastroenterological surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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9 authors.
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Abstract
Background: In right hemicolectomy (RHC) and left-sided transverse colectomy (TC), D3 lymph node dissection is oncologically significant but technically demanding because of marked vascular variability. Standardization requires reliable preoperative anatomical assessment. We evaluated colic vascular anatomy and quantified D3 dissection distance using computed tomography colonography-angiography (CTC-A). Methods: We retrospectively analyzed 591 patients with primary right or transverse colon cancer who underwent preoperative CTC-A during 2014-2023. Arterial origins, venous drainage, and positional relationships around the superior mesenteric artery (SMA) and vein (SMV) were classified. After excluding aberrant cases, branching patterns relevant to D3 dissection were categorized and D3 distances measured along the SMA centerline using curved planar reformation images. Results: An accessory middle colic artery (aMCA) was present in 38.1% of patients (SMA-derived, 76.4%). The MCA originated as a common trunk in 77.8% and as independent branches in 19.0%. The right colic artery (RCA) was observed in 41.8%. Four reproducible vascular patterns each were identified for RHC and TC. In RHC ( Conclusions: High-resolution CTC-A yielded a single-modality, operation-oriented mapping integrating tumor location with mesenteric arteriovenous anatomy. Pattern-based classification and objective D3 distance estimation may support preoperative planning and help establish standardized, safer D3 lymphadenectomy for right-sided and transverse colon cancer.
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