Preoperative segmentation of MultiDetector Computed Tomography Angiography (MDCTA)—solution to vascular variations

The article by Du et al. (1) has caught our attention. The case has been thoroughly presented within the framework of colonoscopy, CT scan, surgical findings, gene sequencing, light microscopy and immunohistochemistry. Our Right Colon Cancer (RCC) study group has accomplished 650 colectomies of the right colon for cancer to this date, with extended mesenterectomy and D3 lymphadenectomy. We regularly perform a minute manual segmentation with 3D reconstruction on preoperative MultiDetector Computed Tomography Angiography (MDCTA) (2-4), which serves as a powerful tool for road-mapping and surgical planning, particularly when the complex, rare and unexpected anatomical variations may occur (2,4). In one of our cases (2), we found a similar (Figure 1), but not identical case as reported by Du et al. We found that the ileocolic artery was very short and promptly divided to the left of the superior mesenteric vein. Further, a preoperative MDCTA segmentation offers the possibility of 3D printing (3), which adds to the practical anatomical orientation before and even during operation. Therefore, we strongly advocate this method for preoperative orientation of surgeons.

Figure 1 A STL file, segmented from the MDCTA. Reused with permission from (2). GTH, gastrocolic trunk of Henle; MCV, middle colic vein; MCA, middle colic artery; ICA, ileocolic artery; ICV, ileocolic vein; JA, jejunal artery; MDCTA, MultiDetector Computed Tomography Angiography.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was a standard submission to the journal. The article did not undergo external peer review.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-22-4711/coif). The authors have no conflicts of interest to declare.

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References

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