A SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) observational prospective multicenter study on anatomical variants of the superior mesenteric artery: intraoperative analysis during laparoscopic right hemicolectomy—CoDIG 2 database (ColonDx Italian Group)

• DOI: 10.1007/s13304-024-01787-6
• Publication Date: 2024-03-25T15:02:00Z
• Authors: G. Anania; A. Campagnaro; M. Chiozza; J. Randolph; G. Resta; S. Marino; S. Pedon; A. Agrusa; D. Cuccurullo; R. Cirocchi
• Keywords: Male; Adult; Aged, 80 and over; Right colic artery; Yada classification; Vascular anatomy; Databases, Factual; Colon; Anatomic Variation; Right hemicolectomy; Middle Aged; Intraoperative Period; Italy; Mesenteric Artery, Superior; Superior mesenteric artery; Humans; Original Article; Laparoscopy; Female; Prospective Studies; Colorectal Neoplasms; Laparoscopy; Right colic artery; Right hemicolectomy; Superior mesenteric artery; Vascular anatomy; Yada classification; Colectomy; Aged

Colorectal cancer, the third most common cancer worldwide, affects 40-45% of patients on right side. Surgery, especially minimally invasive methods such as laparoscopic and robotic procedures, is preferred treatment. However, these techniques present technical complications. The anatomical complexity variations in vessel branching patterns pose challenges, particularly for less experienced surgeons. CoDIG 2 a nationwide observational study involving 76 specialized Italian general surgery departments focused colorectal surgery. centres were directed to maintain their standard surgical clinical practices. aim this was analyse intraoperative vascular anatomy who underwent colectomy explore ligature used by Surgeons reported information about vascularization colon 616 RCA 368 patients. Fifty-three (10.8%) showed no intraoperatively. colic artery (RCA) categorized according Yada classification (types 1-4) during evaluation, assessments revealed that type 1 (55.2%), while radiologic evaluations higher prevalence 2. Furthermore, compared with superior mesenteric vein (SMV), more often located anteriorly contrast-enhanced CT examination; 59.9% found anterior position examination, 40.1% same preoperative CT. Vascularization colon, including missing branches, additional shared trunks, retro-superior courses vein, exhibited notable variations. To understand variations, radiological necessary; although there concordance between evaluations, limitation preinterventional evaluation (PII) because it always needed oncological staging. This approach critical inexperienced surgeons avoid potential complications, problematic bleeding.