Anatomic patterns and clinical significance of gastrocolic trunk of Henle in laparoscopic right colectomy for colon cancer: Results of the HeLaRC trial
机构：[1]Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China[2]Department of Gastrointestinal Surgical Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China[3]Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China广东省中医院[4]Department of Gastrointestinal Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China[5]Section for Surgical Research, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria[6]Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, China江苏省人民医院[7]Genneral Surgical Clinic, Affiliated Hospital of Qingdao University, Qingdao, China[8]Tangdu Hospital, Air Force Medical University, Xi‘an, China[9]Xuanwu Hospital Capital Medical University, Beijing, China首都医科大学宣武医院[10]Daping Hospital,Army Medical University, Chongqing, China[11]Sun Yat-Sen University Cancer Center, Guangzhou, China[12]Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China[13]The First Affiliated Hospital of Soochow University, Suzhou, China[14]Department of Colorectal Surgery, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, China[15]Qinghai University Affiliated Hospital, Qinghai, China[16]Beijing Friendship Hospital, Capital Medical University, Beijing, China首都医科大学附属北京友谊医院[17]Department of Gastrointestinal Surgery, West China Hospital, Chengdu, China四川大学华西医院[18]ShangHai Tenth People’s Hospital of Tongji University, Shanghai, China[19]First Affiliated Hospital of Harbin Medical University, Harbin, China[20]Changhai Hospital, Navy Military Medical University, Shanghai, China[21]Huashan Hospital, Fudan University Shanghai Medical College, Shanghai, China[22]Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China[23]Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China中山大学附属第六医院[24]Second Affiliated Hospital of Fujian Medical University, Fuzhou, China[25]The First Hospital of Jilin University, Changchun, China[26]Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China[27]Department of General Surgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Background: Recent interest in laparoscopic right colectomy with D3 lymphadenectomy for right colon cancer, has raised renewed attention to the anatomic variations of the gastrocolic trunk of Henle acute accent (GTH). Understanding the vascular structure of the GTH region for individual patients should improve surgical outcomes. The goal of this nationwide multicenter study (Anatomical Classification of Henle acute accent 's Trunk in Laparoscopic Right Hemi-colectomy (HeLaRC) trial) was to study the anatomic patterns of the GTH region, to clarify the implications of GTH in laparoscopic right colectomy with D3 lymphadenectomy (D3-RC) and analyze their clinical significance. Methods: We enrolled 583 patients from 26 centers across China who underwent D3-RC. The number of tributaries, length and types of GTH constitutions and their influence on intra-operative data were investigated. A nomogram score (based on the length of GTH, body mass index (BMI), tumor location, T stage and type of GTH (type I vs. non-type I) was established to assess the potential hazard of bleeding. Results: The GTH was found in 567 patients (97.3%). The distribution of GTH types was 0 (14.1%, n = 80), I (53.3%, n = 302), II (27.0%, n = 153), III (5.6%, n = 32). Of note, the type I GTH, T1 stage and tumor location at ileocecal or ascending colon were correlated with shorter exposure time of the GTH region (P < 0.0001). Short length of GTH (P = 0.002) and tumor location (transverse colon vs. non transverse colon) (P = 0.003) were correlated with the amount of GTH bleeding during the surgery. Nomogram discrimination was good (C-index: 0.72 (95% CI: 0.64, 0.80)). The dissection plane was better in patients with type I GTH than with other types (P = 0.023). Conclusion: GTH pattern variations may affect surgical outcomes in patients undergoing D3-RC. Better recognition of GTH anatomy might lead to a safer operation with better oncologic quality.
基金：
Shanghai Municipal Natural Science Foundation [18ZR1424100]; National Major Science and Technol- ogy Infrastructure of Translational Medicine (Shanghai) [TMSK-2021- 503]
第一作者机构：[1]Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
通讯作者：
通讯机构：[1]Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China[*1]Ruijin Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China.
推荐引用方式(GB/T 7714)：
He Zirui,Yang Chunkang,Diao Dechang,et al.Anatomic patterns and clinical significance of gastrocolic trunk of Henle in laparoscopic right colectomy for colon cancer: Results of the HeLaRC trial[J].INTERNATIONAL JOURNAL OF SURGERY.2022,104:106718.doi:10.1016/j.ijsu.2022.106718.
APA：
He, Zirui,Yang, Chunkang,Diao, Dechang,Wu, Deqing,Fingerhut, Abe...&Feng, Bo.(2022).Anatomic patterns and clinical significance of gastrocolic trunk of Henle in laparoscopic right colectomy for colon cancer: Results of the HeLaRC trial.INTERNATIONAL JOURNAL OF SURGERY,104,
MLA：
He, Zirui,et al."Anatomic patterns and clinical significance of gastrocolic trunk of Henle in laparoscopic right colectomy for colon cancer: Results of the HeLaRC trial".INTERNATIONAL JOURNAL OF SURGERY 104.(2022):106718
