Vascular Classification of the Splenic Flexure Vein by Preoperative Three-Dimensional Computed Tomography for Splenic Flexure Colon Cancer Patients.

INTRODUCTION

One reason for the difficulty of surgical resection of splenic flexure cancer may be blood vessel variation around the splenic flexure. Understanding this vessel anatomy is important for safer operations.

METHODS

Sixty-two splenic flexure cancer patients (N = 62) who underwent surgical resection from August 2013 to March 2024 enrolled in this retrospective study. Preoperative three-dimensional computed tomography was conducted for all patients, and splenic flexure morphological vessel patterns, including splenic flexure vein and its accompanying arteries, were investigated. Surgical outcomes were examined for associations with vessel patterns.

RESULTS

The splenic flexure vein (SFV) was present in 49 patients (79.0%). Connecting veins from the SFV were the inferior mesenteric vein (n = 39, 62.9%), left colic vein (n = 6, 9.7%), middle colic vein (n = 2, 3.2%), portal vein, and splenic vein (each n = 1, 1.6%). Thirteen patients (21.0%) showed splenic flexure vein absence. Accompanying arteries included the left branch of the middle colic artery (n = 9, 18.4%), accessory middle colic artery (n = 11, 22.4%), and left colic artery (n = 20, 40.8%). There were no significant differences in outcomes among all groups.

CONCLUSION

Splenic flexure veins and accompanying arteries show variable morphology. Preoperative evaluation of vascular anatomy by three-dimensional computed tomography may be beneficial by contributing to safer operations.