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Purposes <p>To clarify the cranio-caudal positional relationships and inter-root distances among the key mesenteric vessels involved in lymphadenectomy around the superior mesenteric artery (SMA) and the superior mesenteric vein (SMV). These anatomical features have not been investigated systematically before, despite their critical importance for safe and precise complete mesocolic excision (CME) in colon cancer surgery.</p> Methods <p>The subjects of this retrospective study were consecutive patients who underwent dynamic contrast-enhanced abdominal computed tomography (CT) between April, 2024 and March, 2025. We evaluated the presence, branching, and vertical relationships of the artery and vein around the SMA/SMV using CT images with a thickness of 0.625&#xa0;mm. Cranio-caudal distances between the roots of the middle colic artery (MCA) and vein (MCV), and the Henle trunk were measured.</p> Results <p>We analyzed the data for 100 patients. The ileocolic artery, MCA, and MCV were consistently present, while the right colic artery was identified in 36%. The gastro-pancreato-colic type was most common in the Henle trunk (90%). The MCV was located cranial to the MCA in all patients, with a mean inter-root distance of 9.4&#xa0;mm. The typical alignment of MCV, Henle’s trunk, MCA, and cranial to caudal, was present in 85% of the patients.</p> Conclusions <p>The MCV consistently lies cranial to, but with considerable distance from, the MCA. Recognizing these relationships may improve the safety and precision of lymphadenectomy and CME.</p>

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Revisiting the anatomical relationship between the middle colic artery and the middle colic vein for complete mesocolic excision in colon cancer surgery

  • 期刊论文

  • 发表日期：

    2026年3月3日

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  • Takehito Yamamoto,
  • Meiki Fukuda,
  • Yoshihisa Okuchi,
  • Hisatsugu Maekawa,
  • Koji Hisano,
  • Yoshiki Oshimo,
  • Shoichi Kitano,
  • Yu Yoshida,
  • Ryosuke Okamura,
  • Yoshiro Itatani,
  • Koya Hida,
  • Kazutaka Obama,
  • Hiroaki Terajima

摘要

Purposes

To clarify the cranio-caudal positional relationships and inter-root distances among the key mesenteric vessels involved in lymphadenectomy around the superior mesenteric artery (SMA) and the superior mesenteric vein (SMV). These anatomical features have not been investigated systematically before, despite their critical importance for safe and precise complete mesocolic excision (CME) in colon cancer surgery.

Methods

The subjects of this retrospective study were consecutive patients who underwent dynamic contrast-enhanced abdominal computed tomography (CT) between April, 2024 and March, 2025. We evaluated the presence, branching, and vertical relationships of the artery and vein around the SMA/SMV using CT images with a thickness of 0.625 mm. Cranio-caudal distances between the roots of the middle colic artery (MCA) and vein (MCV), and the Henle trunk were measured.

Results

We analyzed the data for 100 patients. The ileocolic artery, MCA, and MCV were consistently present, while the right colic artery was identified in 36%. The gastro-pancreato-colic type was most common in the Henle trunk (90%). The MCV was located cranial to the MCA in all patients, with a mean inter-root distance of 9.4 mm. The typical alignment of MCV, Henle’s trunk, MCA, and cranial to caudal, was present in 85% of the patients.

Conclusions

The MCV consistently lies cranial to, but with considerable distance from, the MCA. Recognizing these relationships may improve the safety and precision of lymphadenectomy and CME.