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Background: This study aims to delineate anatomical landmarks crucial for complete mesocolic excision, focusing on Gerota’s fascia, which guides surgical dissection in right-sided colon cancer, forming the posterior limit. Employing a multimodal approach, the research aims to understand the fascial anatomy and its variations under pathological conditions. Methods: Three methods were applied: a pilot dissection on an embalmed cadaver for clear anatomical presentation of prerenal fascia, Mimics segmentation of the fascia and its relationship with the colon, and a retrospective analysis of MDCTA scans from 196 patients (mean age 65.73 y, 118 F/78 M). Systematic measurements of fascial thickness were taken at key renal levels—upper pole, hilum, lower pole, and infra-renal. Covariates analyzed included Body Mass Index, age, and sex. Results: The pilot dissection revealed the renal fascia of Gerota as the only true retrocolic compact connective tissue and the fusion fascia of Toldt as a mesh of strands of loose connective tissue and fat lobules. MDCTA showed clearer visualization of Gerota’s fascia at the hilum and inferior renal pole, predominantly on the left. There were significant differences in fascial thickness between sides (1.30 mm on the right and 1.34 mm on the left) and a positive correlation with BMI, whereas age and sex showed no significant effects. Conclusion: Gerota’s fascia is a critical anatomical landmark in CME for right colon cancer. This study highlights the fascia’s structural integrity, unaffected by the tumor, underscoring its importance in surgical navigation.

This communication study integrates composite multimodal research on postmortem human submandibular glands, based on macromorphometry. The normal ductographic sialograms were pairwise analyzed using linear morphometry, whole-gland planimetry and fractal properties, such as main duct length, caliber and tortuosities, side branches and accessory ducts/lobes. All the examined parameters presented a significant correlation, i.e., symmetry between the left and the right submandibular glands. The morphometric data presented can serve as a valuable reference in clinical practice.

Abstract Background The objectives of this study were to evaluate the relationship between ductal morphometry and ramification patterns in the submandibular gland and pancreas in order to validate their common fractal dimension. Methods X-ray ductography with software-aided morphometry were obtained by injecting barium sulphate in the ducts of post-mortem submandibular gland and pancreas specimens harvested from 42 adult individuals. Results Three cases were excluded from the study because of underlying pathology. There was a significant correlation between the length of the main pancreatic duct (MPD) and the intraglandular portion of the right submandibular duct (SMD) (r = 0.3616; p = 0.028), and left SMD (r = 0.595; p 0.05). Both dimensions of the SMD showed a significant right-left correlation (p

Background: There seems to be a gap in knowledge of the anatomy of mesenteric lymphatics between the superior mesenteric nodes and the intestinal trunk. To our knowledge, these central lymph vessels were not hitherto systematically searched for, described, or morphometrically analyzed. Our aim was to identify those vessels on the routine multidetector computerized tomography angiography (MDCTA), performed prior to right colectomy for cancer, with extended mesenterectomy, central vascular ligation, and D3 lymphadenectomy. Methods: A total of 420 MDCTA datasets were analyzed utilizing manual segmentation and 3D reconstruction, with the aid of image processing software Osirix, Mimics, and 3-matic. The 3D models and masks underwent a detailed topographic and morphometric analysis. Results: Significant vascular-like structures, having neither origin nor termination on the blood vessels, were noted in 18 cases (4.3%) in the D3 volume. The dimensions of visible lymph vessels varied, their mean diameter was 1.81 ± 0.61 mm, and the mean length was 38.07 ± 22.19 mm. In the vast majority of cases, the lymph vessels were situated in front of the superior mesenteric artery (SMA), coursing either longitudinally cranially (13 cases) or transversely/obliquely to the left (5 cases). In all cases but one, the lymph vessel passed at the left-hand side of the middle colic artery. As for the course shape, in seven cases, the lymph vessel appeared highly serpiginous. Conclusions: The regular MDCTA can provide valuable information on mesenteric lymphatics and aid in surgical planning.