Discuss The Variation Of The Right Colon Vessels Anatomical And Treatment Of Vascular Surgeryon Laparoscopic Right Hemicolectomy

Objective We discuss the variation of the right colon vessels anatomy,combining our experiences about laparoscopic right hemicolectomy in our center,so as to share specific surgical skills to evading vascular complications of this surgery.Methods Videotapes of 74 laparoscopic right hemicolectomieswere collected at department of oncological surgery,during from March 2013 to October 2016.Among them,14 non-standard cases were excluded,surgical records were included in 60 patients finally,which were statistically analyzed of the right-colon-vessels variation.Results Among 60 cases,the superior mesenterie vein,superior mesenteric artery were present in all the patients;The superior mesenteric artery was located on the left side of superior mesenteric vein in 57 cases(n = 95%),and the right side in the other group(n = 3)(n = 5%).The occurrence probability of ileocolic artery and ileocolic vein were 96.7%(58/60)and 100%(60/60)respectively,among them,the ileocolic artery of 50%(n=29)cases crossed from the superior mesenteric vein.The occurrence probability of right colic artery was 55.5%(33/60),among them,the right colic artery of 90.9% c(n=30)cases crossed from the superior mesenteric vein.The occurrence probability of right colic vein was 93.3(53/60),among them,the route of right colic artery and right colic vein was alike in 7 cases(n=13.2%);In addition,The right colic vein enters the gastrocolic vein and directly into the superior mesenteric vein cases were 37 cases(66.1%),13 cases(23.2%);Besides,one right colic vein was superior to the superior mesenteric vein,and the other one were injected into the gastrocolic vein in 6 cases(10.7%).The occurrence probability of gastrocolic vein was 88.3%(53/60),included 19(n=35.8%)gastrocolic trunk,5(n=9.4%)gastropancreatic trunk and 29(n=54.7%)gastropancreaticocolic trunk.The occurrence probability of middle colic artery was 100%(60/60),and the distance between the bifurcation point and the starting point is in the range of 1 to 2cm.The occurrence probability of middle colic vein was 93.3%(56/60),of the 45 cases(80.4%),there were 1 middle colic vein,;and of the 9 cases(16.1%),there were 2 middle colic veins,and of the 2 cases(3.6%),there were 3 middle colic veins.Conclusions When surgeon underwent laparoscopic radical resection assisted right hemicolectomy,vascular variation were complex and changeable.Statistical analysis of vascular variation of right colonic vascular and discuss the surgical techniques for the treatment of vascular surgery can avoid intraoperative and postoperative complications and improve the prognosis of patients.