Vascular Reconstruction With Autologous Venovenous Grafting After Complete Transection of the Superior Mesenteric Vein (SMV) During Right Hemicolectomy (RH) With Complete Mesocolic Excision (CME)

Right hemicolectomy (RH) with complete mesocolic excision (CME) for right-sided colon cancer has been recommended by experts as the optimal approach in terms of oncologic and survival outcomes. However, intraoperative adverse events, such as iatrogenic vascular injuries, are more commonly associated with CME as opposed to the conventional method. This report delineates a severe injury to the superior mesenteric vein (SMV) with complete transection of the vessel during RH/CME, which was definitively managed with autologous venovenous grafting. Awareness of the risks, familiarity with the anatomy, and adequate training are mandatory for colorectal surgeons in order to master a technique with a steep learning curve and be able to manage potentially disastrous complications.