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This study aims to define lymphovascular bundles of the terminal ileal artery (TIA) and subsequent ileal arteries. It also aims to extrapolate results from two distinct methodologies to define the level of arterial ligation and the dissection area for radical and bowel-sparing surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Analysis of 3D-CT mesenteric vascular reconstructions of 104 operated patients. The second dataset consisted of 5 human cadavers for anatomical dissection. In one case, harvested viscera underwent the superior mesenteric artery (SMA) perfusion after ligation of the TIA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The calibers of the first three ileal arteries were: 2.67\u2009\u00b1\u20090.98\u00a0mm, 2.22\u2009\u00b1\u20090.78\u00a0mm, 2.31\u2009\u00b1\u20091.24\u00a0mm. The distances from the first three ileal arteries to the ileocolic artery (ICA) origin were: 12.45\u2009\u00b1\u20098.79\u00a0mm, 27.45\u2009\u00b1\u200913.47\u00a0mm, and 43.04\u2009\u00b1\u200916.94\u00a0mm. The SMA trifurcated in 61 (59%) of cases and bifurcated in 43 (41%). In 89 cases, the combined ICA\u2009+\u2009first jejunal artery caliber (6.7\u2009\u00b1\u20091.6\u00a0mm) was greater than the TIA caliber (4.84\u2009\u00b1\u20091.42\u00a0mm). The ileal artery lymphatic clearances were 0.85\u00a0mm to the preceding vessel. In the D3 volume at the ICA origin, 3\u20138 lymph nodes were observed. Internal calibers of the small bowel marginal artery, after selective TIA ligation and the SMA perfusion, were: proximal jejunal part 0.417\u00a0mm and distal ileal part 0.291\u00a0mm.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Ileal tumors are irrigated through the TIA, which can be ligated without consequences. Lymphadenectomy should encompass the adjacent vessels (1st jejunal artery, ICA) and can include the central nodes (D3 volume) at the surgeon\u2019s preference. Preserving the adjacent vessels and the marginal artery is paramount for bowel-sparing surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00464-025-11590-y","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T16:59:44Z","timestamp":1740589184000},"page":"2711-2720","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Lymphatic and vascular anatomy define surgical principles for bowel-sparing radical treatment of ileal tumors"],"prefix":"10.1007","volume":"39","author":[{"given":"Teodor","family":"Vasic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Stimec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bojan Vladimir","family":"Stimec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8565-0568","authenticated-orcid":false,"given":"Dejan","family":"Ignjatovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"11590_CR1","first-page":"298","volume":"1","author":"P Descomps","year":"1922","unstructured":"Descomps P, Turnesco D (1922) Les grands courants lymphatiques de l\u2019abdomen, leur convergence, leurs ganglions satellites. 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