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Safe D3 Right Hemicolectomy for Cancer Through 3D MDCT Angiography Reconstruction

20 Years
75 Years
Open (Enrolling)
Colon Cancer

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Trial Information

Safe D3 Right Hemicolectomy for Cancer Through 3D MDCT Angiography Reconstruction

The Norwegian gastrointestinal cancer group has recommended D3 resection as the standard
operative technique for colon cancer. D3 resection implies ligation of the blood vessels at
their origin. There is evidence that the recurrence free period and survival improves with
the number of lymph nodes harvested at surgery. However, the current practice in Norway,
while performing right hemicolectomy for cancer is to ligate the feeding vessels for the
right colon on the right hand side of the superior mesenteric vein (SMV). Significant
arterial stumps have been demonstrated in patients operated for right colon cancer with this
technique (right colic artery and ileocolic artery vascular stumps with an average length of
3.5 cm and 2.5 cm, respectively). This leaves reason to believe that a certain number of
central lymph nodes remain after the procedure.

The complex anatomical relationship between the right colic artery and ileocolic artery with
the superior mesenteric vein make D3 resection demanding, especially if the right colic
artery lies posterior to the SMV. These relationships are investigated in detail in
postmortem anatomical studies. These studies show that the right colic artery lies most
often anterior to the SMV, while the ileocolic artery lies most often posterior to the SMV.
Data has also been provided that a CT angiography can verify these relations as well as
postmortem anatomical studies in living patients, thus allowing the surgeon to be aware of
them prior to surgery. This could prove to be crucial in planning the procedure.

Inclusion Criteria:

- Patients with histo-pathologically verified adeno-carcinoma of the right colon

- Patients under the age of 75

- Patients medically cleared by anesthesiologist for general anesthesia

- Signed informed consent form

Exclusion Criteria:

- Patients with recurrent cancer after previous surgery

- Patients with distant metastasis

- Patients who are not medically cleared to undergo anesthesia

- Patients who do not sign the informed consent form

Type of Study:


Study Design:

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Number of additional lymph nodes removed through radical D3 resection

Outcome Description:

The short term outcome of this study will compare number of lymph nodes removed, operating time and complications between the two groups.

Outcome Time Frame:

1 year

Safety Issue:



Norway: Regional Ethics Commitee

Study ID:

D3 MDCT angio



Start Date:

May 2011

Completion Date:

May 2017

Related Keywords:

  • Colon Cancer
  • D3 resection
  • right colectomy
  • MDCT angiography
  • lymphadenectomy
  • safe
  • right colon
  • preoperative
  • Colonic Neoplasms