Kaye, TL, West, NP orcid.org/0000-0002-0346-6709, Jayne, DG orcid.org/0000-0002-8725-3283 et al. (1 more author) (2016) CT assessment of right colonic arterial anatomy pre and post cancer resection - a potential marker for quality and extent of surgery? Acta Radiologica, 57 (4). pp. 394-400. ISSN 0284-1851
Abstract
Background: There is conflicting opinion as to the optimum extent of resection for right-sided colonic cancer, which is currently graded by pathological analysis of the resected specimen. It is not known if computed tomography (CT) analysis of residual post-resection arterial stump length could be used as an alternative in vivo marker for extent of mesenteric resection. Ileocolic artery stumps have been demonstrated previously on CT after right hemicolectomy, but only in the early postoperative period. Purpose: To analyze preoperative right colonic arterial anatomy using portal venous colorectal cancer staging CT and subsequently determine if post-resection arterial stumps (a potential in vivo marker of surgical resection) could be consistently identified using routine follow-up CT scans many months after cancer resection. Material and Methods: A retrospective analysis of routine staging and follow-up CT scans for 151 patients with rightsided colorectal cancer was performed. Preoperative right colonic arterial anatomy and postoperative arterial stumps were analyzed and measured. Results: Preoperative ileocolic (98.8%), middle (94.7%), and right colic artery (23.8%) identification was comparable to catheter angiogram studies. Postoperative ileocolic stumps were consistently demonstrated (88.3%) many months (average, 2 years and 42 days) after resection and were significantly longer than expected for a standard D2 resection (paired t-test, t(127) ¼ 11.45, P 0.001). Conclusion: This is the first study to successfully demonstrate ileocolic arterial stumps many months (and years) after cancer resection using routine portal venous CT. Further prospective research should assess whether arterial stumps can be used as an in vivo marker of surgical quality and extent.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2015, The Foundation Acta Radiologica. This is an author produced version of a paper published in Acta Radiologica. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Abdomen; GI; computed tomography (CT); quantitative; large bowel; arteries; surgery; primary neoplasms |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Biomed & Clin Sciences (LIBACS) (Leeds) > Trans Anaesthetics & Surgical Sciences (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cancer and Pathology (LICAP) > Pathology & Tumour Biology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 05 Jan 2017 10:00 |
Last Modified: | 21 Jan 2018 07:42 |
Published Version: | https://doi.org/10.1177/0284185115583033 |
Status: | Published |
Publisher: | SAGE Publications (UK and US) |
Identification Number: | 10.1177/0284185115583033 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:109830 |