Right colic artery anatomy: a systematic review of cadaveric studies

Abstract

BackgroundComplete mesocolic excision for right-sided colon cancer may offer an oncologically superior excision compared to traditional right hemicolectomy through high vascular tie and adherence to embryonic planes during dissection, supported by preoperative scanning to accurately define the tumour lymphovascular supply and drainage. The authors support and recommend precision oncosurgery based on these principles, with an emphasis on the importance of understanding the vascular anatomy. However, the anatomical variability of the right colic artery (RCA) has resulted in significant discord in the literature regarding its precise arrangement.MethodsWe systematically reviewed the literature on the incidence of the different origins of the RCA in cadaveric studies. An electronic search was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-analyses recommendations up to October 2016 using the MESH terms ‘right colic artery’ and ‘anatomy’ (PROSPERO registration number CRD42016041578).ResultsTen studies involving 1073 cadavers were identified as suitable for analysis from 211 articles retrieved. The weighted mean incidence with which the right colic artery arose from other parent vessels was calculated at 36.8% for the superior mesenteric artery, 31.9% for the ileocolic artery, 27.7% for the root of the middle colic artery and 2.5% for the right branch of the middle colic artery. In 1.1% of individuals the RCA shared a trunk with the middle colic and ileocolic arteries. The weighted mean incidence of 2 RCAs was 7.0%, and in 8.9% of cadavers the RCA was absent.ConclusionsThis anatomical information will add to the technical nuances of precision oncosurgery in right-sided colon resections.

Analysis of the Variations in the Colic Branching Pattern of the Superior Mesenteric Artery: A Cadaveric Study with Proposal to Modify Its Current Anatomical Classification

“…RCA arising as a branch of ICA is also commonly reported [18, 21,22] while RCA shared a CS with ICA reported rarely [17]. In the present study, only one case (2.85%) was observed where RCA was sharing CS with ICA, whereas Jain & Motwani [16] reported such variant mode of origin of RCA in 25% of study population.…”

“…Reviewing literature showed that RCA may arise from the root of the MCA or from its right branch. Most of the researchers have reported RCA arising from the root of MCA [17,18,21], While very few people observed RCA to arise from its right branch [22].…”

An Unconventional Origin of the Right Colic Artery: A Case Report

“…The incidences of the right colic-middle colic common stem extended from 3.33% [8] to 52% [9]. Our literature search revealed the work of Haywood, et al (2017) to be the only systematic review of the variations of right colic artery origin, their paper reviewing the rate of incidence of the right colic artery origin and reporting a revised incidence of 27.7% [4].…”

“…Smaller arterial branches of the inferior and superior divisions of the right colic artery go on to supply the distal two-thirds of the ascending colon and the hepatic flexure [3]. Occasionally, the right colic artery's parent vessel may not be the superior mesenteric artery, instead sharing a common trunk with a neighbouring artery before dividing into its branches to supply the colon, or being absent altogether [4]. Our work articulates an unconventional origin of the right colic artery, the incidence of this variation in the current literature, as well as the significance of this morphology within a clinical context.…”

Minimally invasive complete mesocolic excision for right colon cancer

“…The right colic arising from the SMA was only present in 10.7% of the cases. A recent systematic review of cadaveric studies 30 involving ten studies and 1073 cadavers, described how the anatomical variability of the RCA resulted in significant discord within the published literature. A systematic review and meta‐analysis of the surgical anatomy of the superior mesenteric vessels by Negoi et al 28 showed that the venous drainage of the right side of the colon, which includes the infra‐pancreatic anatomy of the superior mesenteric veins, was also widely variable.…”