title: Evaluation of the vascular anatomy of the right-sided colon using three-dimensional computed tomography angiography: a single-center study of 536 patients and a review of the literature.
abstract: OBJECTIVE
  The requisite for a rigorous preoperative understanding of vascular branching continues to grow in parallel with the implementation of laparoscopic surgery. Three-dimensional (3D)-computed tomography (CT) angiography is a less-invasive modality than traditional angiographic examination. Therefore, we aimed to evaluate branching patterns of the superior mesenteric artery (SMA).
  
  
  METHODS
  In the present study, 536 consecutive patients who underwent preoperative 3D-CT angiography from April 2012 to March 2014 were prospectively enrolled. The branching pattern of the right colic artery (RCA) and the intersectional patterns of the RCA, ileocolic artery (ICA), and superior mesenteric vein (SMV) were evaluated.
  
  
  RESULTS
  The RCA existed in only 179 cases (33.4 %); the remaining 357 patients (66.6 %) lacked evidence of the RCA. The ICA was detected in all cases. The RCA ran ventral to the SMV in the majority of cases (89.4 %). Conversely, the ICA ran ventral to the SMV in only half of the cases (50.6 %). When the RCA was observed to pass dorsal to the SMV, the ICA also ran dorsal to SMV in all cases.
  
  
  CONCLUSIONS
  3D-CT angiography can aid surgeons in identifying and understanding the anatomical vascular variations and intersectional patterns of the RCA, ICA, and SMV. Developing awareness of these variations can aid in the prevention of unexpected vascular injury during laparoscopic right-sided colon surgery.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. MURONOK-SUR@h.u-tokyo.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Murono
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kawai
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ishihara
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Otani
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yasuda
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishikawa
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Tomomichi
authors.initials: T
authors.lastname: Kiyomatsu
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hata
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nozawa
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamaguchi
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000033:anatomy & histology* / Q000098:blood supply* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D017538:Mesenteric Artery, Superior / Q000033:anatomy & histology; D008642:Mesenteric Veins / Q000033:anatomy & histology; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: 3D-CT angiography; Anatomy; Right-sided colon; Superior mesenteric artery