Two Types of Variational Arteries' Courses From the Superior Mesenteric Artery to Supply the Splenic Flexure: Gross Anatomical Study. Dis Colon Rectum. 2024;67(1):120-128.

<jats:sec> <jats:title>BACKGROUND:</jats:title> <jats:p>Complete mesocolic excision with central vascular ligation is a standard method for managing colon cancer. However, there is no consensus on its procedure, especially for cancer in the splenic flexure of the transverse colon. This is because various types of variational arteries are distributed to the region, and their running course below and near the pancreas leads to difficulty in ligating the artery.</jats:p> </jats:sec> <jats:sec> <jats:title>OBJECTIVE:</jats:title> <jats:p>To clarify the arterial distribution to the splenic flexure of the transverse colon using cadavers.</jats:p> </jats:sec> <jats:sec> <jats:title>DESIGN:</jats:title> <jats:p>The arteries in the transverse mesocolon distributed to the colon were dissected in cadavers, and their route was quantitatively visualized using drawing software.</jats:p> </jats:sec> <jats:sec> <jats:title>SETTINGS:</jats:title> <jats:p>This study was conducted at the Department of Anatomy, Tokyo Medical University.</jats:p> </jats:sec> <jats:sec> <jats:title>PATIENTS:</jats:title> <jats:p>Sixty cadavers donated to Tokyo Medical University in 2017–2021 were used.</jats:p> </jats:sec> <jats:sec> <jats:title>MAIN OUTCOME MEASURES:</jats:title> <jats:p>The arterial courses to the splenic flexure of the transverse colon in the mesocolon and their patterns were evaluated.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS:</jats:title> <jats:p>We found 34 variational arteries distributed to the splenic flexure of the transverse colon. Most originated from the superior mesenteric artery and the middle colic artery, with their typical course below the pancreas. We identified another arterial course, crossing the mesocolon away from the pancreas toward the splenic flexure of the transverse colon. Furthermore, the origin of these arteries was not behind the pancreas and can be found in the caudal region of the pancreas.</jats:p> </jats:sec> <jats:sec> <jats:title>LIMITATIONS:</jats:title> <jats:p>We cannot discuss how the arteries within the transverse mesocolon are observed by CT examination.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS:</jats:title> <jats:p>This study showed 2 types of arterial courses (below the pancreas and within the mesocolon) toward the splenic flexure of the transverse colon for the first time. In the latter case, the complete mesocolic excision with central vascular ligation is likely performed more easily than in the former. See Video Abstract.</jats:p> </jats:sec> <jats:sec> <jats:title>DOS TIPOS DE RECORRIDO VARIACIONAL DE LA ARTERIA DESDE LA ARTERIA MESENTÉRICA SUPERIOR PARA IRRIGAR EL ÁNGULO ESPLÉNICO: ESTUDIO ANATÓMICO MACROSCÓPICO</jats:title> <jats:p> <jats:bold>ANTECEDENTES:</jats:bold> </jats:p> <jats:p>La escisión mesocólica completa con ligadura vascular central es un método estándar para el cáncer de colon. Sin embargo, no hay consenso sobre su procedimiento, especialmente para el cáncer en el ángulo esplénico del colon transverso. Esto se debe a que varios tipos de arterias variacionales se distribuyen en la región, y su recorrido por debajo y cerca del páncreas dificulta la ligadura de la arteria.</jats:p> <jats:p> <jats:bold>OBJETIVO:</jats:bold> </jats:p> <jats:p>Este estudio tuvo como objetivo aclarar la distribución arterial al SF del colon transverso utilizando cadáveres.</jats:p> <jats:p> <jats:bold>DISEÑO:</jats:bold> </jats:p> <jats:p>Las arterias en el mesocolon transverso distribuidas al colon fueron disecadas en cadáveres, y su ruta fue visualizada cuantitativamente utilizando un software de dibujo.</jats:p> <jats:p> <jats:bold>AJUSTES:</jats:bold> </jats:p> <jats:p>Este estudio se realizó en el Departamento de Anatomía de la Universidad Médica de Tokio.</jats:p> <jats:p> <jats:bold>PACIENTES:</jats:bold> </jats:p> <jats:p>Se utilizaron sesenta cadáveres donados a la Universidad Médica de Tokio en 2017-2021.</jats:p> <jats:p> <jats:bold>PRINCIPALES MEDIDAS DE RESULTADO:</jats:bold> </jats:p> <jats:p>Se evaluaron los cursos arteriales al áng ...