title: The anatomical and surgical consequences of right colectomy for cancer.
abstract: BACKGROUND
  Current practice when performing right colectomy for cancer is to divide the feeding vessels for the right colon on the right side of the superior mesenteric vein.
  
  
  OBJECTIVE
  This study aims to show that arterial stumps can be visualized through an early postoperative CT and analyze their anatomical and surgical characteristics.
  
  
  METHODS
  This study presents a retrospective review of prospective data.
  
  
  METHODS
  :The study was conducted at the Department of Surgery, Vestfold Hospital, Tonsberg, Norway.
  
  
  METHODS
  Patients with leakage after a right colectomy for cancer (2003-2011) were identified through a local prospective complication registry (FileMaker Pro 9.0v3 software).
  
  
  METHODS
  Both preoperative and postoperative CTs were retrieved, reanalyzed, and 3-dimensionally reconstructed (Osirix v.3.0.2./Mimics v.13.1.). Patients without postoperative CTs were excluded.
  
  
  METHODS
  The main outcomes measured were length, caliber of presumed and actual arterial stumps, and their position relative to the superior mesenteric vein.
  
  
  RESULTS
  Eighteen patients, median age 69 (10 men) were included. All patients had postoperative CTs, and 15 patients had preoperative CTs. Median time from operation to postoperative CT was 5 days. The ileocolic artery was found in 14 (11 CT pairs) patients, and the right colic artery was found in 5 (4 pairs) patients. Actual stump lengths were 28.0 mm (SD 9.3) and 37.3 mm (SD 14.9). A significant statistical difference between presumed and actual ileocolic artery stump lengths was found (P = .002). Posterior crossing to the superior mesenteric vein was noticed in 8 of 14 ileocolic arteries and in 3 of 5 right colic arteries. There was no statistical difference in mean caliber for the preoperative and postoperative right colic artery (P = .505) and ileocolic artery (P = .474).
  
  
  CONCLUSIONS
  Difficulties when interpreting the postoperative images, due to intra-abdominal effusion, staples, edema, and altered syntopy of blood vessels, were overcome through comparison with preoperative CTs.
  
  
  CONCLUSIONS
  An early postoperative CT can show arterial stumps after right colectomy for cancer. These stumps appear to be significantly longer than presumed; implying a significant improvement potential when specimen size is concerned.
authors: Department of Gastrointestinal Surgery, Vestfold Hospital, Tonsberg, Norway.
authors: Milan
authors: M
authors: Spasojevic
authors: Bojan V
authors: BV
authors: Stimec
authors: Lars Bergene
authors: LB
authors: Gronvold
authors: Jens-Marius
authors: JM
authors: Nesgaard
authors: Bjorn
authors: B
authors: Edwin
authors: Dejan
authors: D
authors: Ignjatovic
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000601:surgery; D001158:Arteries; D003082:Colectomy; D003106:Colon / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies