Impact of Vascular Variations of Superior Mesenteric Artery During Complete Mesocolic Excision for Right Colon Cancer
Bibliographic record
Abstract
Background: Looking for anomalies and vascular control gains a central role in colon cancer surgery. Complete mesocolic excision (CME) presents technical challenges, primarily due to the considerable variability in the arterial configuration of the right colon. The importance of understanding colonic vascular anatomy has become more prominent with the adoption of this surgical technique. The aim of this study is to systematically review the vascular anatomical variations in the superior mesenteric artery (SMA) in the setting of extended lymphadenectomy for CME in right colon cancer and to show its impact in clinical practice. Methods: A systematic review of the literature on Medline (PubMed), Web of Science (WOS), and Scopus was performed according to PRISMA guidelines. The following criteria were set for inclusion: (1) studies reporting minimally invasive (robotic, laparoscopic, and hybrid techniques) or open CME/D3 lymphadenectomy; (2) studies reporting patients with right-sided colon cancer; (3) studies reporting the description or illustration of SMA variations. The methodological quality of all included studies was evaluated using the Newcastle–Ottawa Scale (NOS). Results: After the literature search, 800 studies were recorded, 31 studies underwent full-text reviews, and 9 studies met the inclusion criteria. All studies reported vascular variations in SMA, and the total number of patients was 813. No intraoperative complications were reported. In 6.4% of patients, post-operative bleeding occurred. Conclusions: Vascular anatomical variations are not a rare entity. In experienced centers, vascular anomalies are not associated with an increase in complications, both in traditional open and minimally invasive surgery (MIS). However, in MIS, full access to central vessels and intraoperative vascular control, moderate retraction, safety maneuvers, and accurate vascular dissection are mandatory.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.048 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".