Anatomical characteristics and classifications of gastrocolic trunk of Henle in laparoscopic right colectomy: preliminary results of multicenter observational study

He, Zengyou; Su, Hao; Yang, Kai; Sun, Yueming; Guo, Yincong; Wang, Quan; Li, Yong; Diao, Dechang; Yang, Chen; Wu, Nan; Li, Ang; Tong, Weidong; Ding, Pei-Rong; Xiao, Yi; Zhou, Xiaojun; Song, Zhangfa; Su, Yan; Yao, Hongwei; Wei, Meng; Zhou, Donglei; Zhu, Aiguo; Gao, Yuan; Wang, Hao; Zhou, Yiming; Li, Xinxiang; Kang, Liang; Zheng, Min; Feng, Bo

doi:10.1007/s00464-019-07247-2

Cited by 13 publications

(9 citation statements)

References 25 publications

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“…Traditionally, the boundaries of the lymphadenectomy have been described using vascular landmarks, even though vascular anomalies or aberrant vessels are relatively common [27][28][29] and the D3 area is not precisely defined, with terminology that has changed over time [9,14]. In addition, while most patients have a similar pattern of lymphatic drainage, a number of reports have demonstrated individual variability as well as unusual routes of extramesocolic diffusion [11,30].…”

Section: Discussionmentioning

confidence: 99%

ICG-Guided Lymphadenectomy during Surgery for Colon and Rectal Cancer—Interim Analysis of the GREENLIGHT Trial

et al. 2022

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Lymphadenectomy is crucial for an optimal oncologic resection of colon and rectal cancers. However, without a direct visualization, an aberrant route of lymph node (LN) diffusion might remain unresected. Indocyanine-green (ICG) lymphatic mapping permits a real-time LNs visualization. We designed the GREENLIGHT trial to explore in 100 patients undergoing robotic colorectal resection the clinical significance of a D3 ICG-guided lymphadenectomy. The primary endpoint was the number of patients in whom ICG changed the extent of lymphadenectomy. We report herein the interim analysis on the first 70 patients. After endoscopic ICG injection 24 h (n = 49) or 72 h (n = 21) ahead, 19, 20, and 31 patients underwent right colectomy, left colectomy, and anterior rectal resection. The extent of lymphadenectomy changed in 35 (50%) patients, mostly (29 (41.4%)) for the identification of LNs (median two) outside the standard draining basin. Identification of such LNs was less frequent in rectal tumors that had undergone chemoradiotherapy (26.3%) (p > 0.05). A non-significant correlation between time-to-ICG injection and identification of aberrant LNs was observed (48.9% at 24 h vs. 23.8% at 72 h). The presence of LN metastases did not affect a proper fluorescent mapping. These data indicate that ICG lymphatic mapping provides relevant information in 50% of patients, thus increasing the accuracy of potentially curative resections.

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Section: Discussionmentioning

confidence: 99%

ICG-Guided Lymphadenectomy during Surgery for Colon and Rectal Cancer—Interim Analysis of the GREENLIGHT Trial

et al. 2022

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“…Normally, the GCT is formed by the RGEV, ASPDV and RCV, and other colic veins might flow into the GCT. According to a previous study [ 3 ], the RCV did not drain into the GCT in 15% of patients. In that study, one right colic vein flowed into the GCT in 51.8% of patients, two right colic veins in 11.6%, and one right colic vein and one middle colic vein drained into the GCT in 13.6% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…In our case, the MCV, RGEV, ASPDV and ICV drained into the GCT. The incidence of this variation of the ICV draining directly into the GCT was reported to range from 1.8 to 2.7% using intraoperative imaging [ 3 ], cadaver studies [ 4 ] and radiologic imaging [ 5 ]. Only one previous report by He et al described the preoperative diagnosis of this type of vascular anomaly [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

A case in which the ileocolic vein draining into the gastrocolic trunk of Henle could be diagnosed preoperatively: a rare anatomical case report

et al. 2022

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Background Numerous variations in vascular anatomy have been reported in the right colon. The ileocolic vein (ICV) generally drains directly into the superior mesenteric vein (SMV), and is an important landmark for laparoscopic surgery in right colon cancer. We present here a patient with a vascular anomaly of the ICV that was diagnosed on preoperative imaging. Case presentation A 65-year-old woman was diagnosed with transverse colon cancer by colonoscopy. Preoperative computed tomography scan showed that the ICV drained into the gastrocolic trunk of Henle (GCT) rather than the SMV. Single-incision laparoscopic transverse colectomy with D3 lymph node dissection was performed, dividing the middle colic vein (MCV) and preserving the right gastroepiploic vein (RGEV), anterior superior pancreaticoduodenal vein (ASPDV), GCT and ICV. The intraoperatively identified venous anatomy was consistent with the preoperative evaluation, and the RGEV, ASPDV and ICV were found to form the GCT. Conclusion We report a rare vascular anatomical anomaly that was diagnosed preoperatively, facilitating safe and successful single-incision laparoscopic surgery with D3 lymph node dissection.

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“…70 He et al reported the characteristics of GTH based on intraoperative findings during LRH from 371 patients. 71 In their study, GTH was present in 97.8% of patients (363 of 371), and it was most commonly formed with the right colic vein alone. They emphasized the relatively short length of GTH (8.5 mm on average, ranging from 2 to 30 mm), which might carry a risk of bleeding.…”

Section: Complete Mesocolic Excision Study (Comes) By Danish Colorectalmentioning

confidence: 92%

Current status and trend of laparoscopic right hemicolectomy for colon cancer

Matsuda

Yamashita

Hasegawa

et al. 2020

Annals of Gastroent Surgery

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Since the first report of laparoscopic surgery for colorectal cancer in 1991, 1 its popularity has been increasing worldwide based on evidence that laparoscopic surgery provides better short-term outcomes and similar oncological outcomes compared with open surgery, supported by previous large randomized clinical trials (RCTs). 2-5 Laparoscopic right hemicolectomy (LRH) is one of the most common procedures in colorectal cancer surgery, which is employed for right-sided colon cancer. However, it has several unique issues unlike other colorectal cancer surgeries. There were several different approaches for lymph node dissection (i.e. medial-to-lateral, lateral-to-medial, and cranial-to-caudal) and reconstruction (i.e. intracorporeal and extracorporeal). Furthermore, there are anatomical variations in vascular structures encountered during LRH, and various landmarks have been proposed for a successful surgery.

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Anatomical characteristics and classifications of gastrocolic trunk of Henle in laparoscopic right colectomy: preliminary results of multicenter observational study

Cited by 13 publications

References 25 publications

ICG-Guided Lymphadenectomy during Surgery for Colon and Rectal Cancer—Interim Analysis of the GREENLIGHT Trial

ICG-Guided Lymphadenectomy during Surgery for Colon and Rectal Cancer—Interim Analysis of the GREENLIGHT Trial

A case in which the ileocolic vein draining into the gastrocolic trunk of Henle could be diagnosed preoperatively: a rare anatomical case report

Current status and trend of laparoscopic right hemicolectomy for colon cancer

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