The Short-Term Outcomes of Gastric Cancer Patients Based on a Proposal for a Novel Classification of Perigastric Arterie
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ORIGINAL ARTICLE
The Short-Term Outcomes of Gastric Cancer Patients Based on a Proposal for a Novel Classification of Perigastric Arteries Shuai Shen 1 & Shougen Cao 1 & Haitao Jiang 1 & Shanglong Liu 1 & Xiaodong Liu 1 & Zequn Li 1 & Dan Liu 1 & Yanbing Zhou 1 Received: 11 June 2019 / Accepted: 30 September 2019 # 2019 The Society for Surgery of the Alimentary Tract
Abstract Purpose To establish a novel classification of perigastric arteries by computerized tomography angiography (CTA) and discuss its influence in patients’ short-term clinical outcomes. Methods The clinical data were analyzed retrospectively from 680 gastric cancer patients. The types of the perigastric artery were classified according to CTA image and we compared the short-term clinical outcomes. Results The perigastric arteries can be divided into seven categories. Type I, trifurcation of the celiac trunk (CT) (294/343, 85.7%); type II, hepatosplenic trunk, left gastric artery (LGA) arising from the abdominal aorta (8/343, 2.3%); type III, hepatogastric trunk, splenic artery arising from the superior mesenteric artery (SMA) (2/343, 0.6%); type IV, celiacomesenteric trunk (5/343, 1.5%); type V, common hepatic artery (CHA) arising from the SMA, gastrosplenic trunk (11/343, 3.2%); type VI, aberrant (accessory or replaced) left hepatic artery arising from LGA (21/343, 6.1%); and type VII, CHA arising from LGA (2/343, 0.6%). The number of retrieved LNs in the CTA group was significantly higher than that in the non-CTA group. However, the operation time, estimated blood loss, intraoperative vascular injury, and medical cost of the CTA group were significantly less than those in the non-CTA group. Of note, in patients with BMI ≥ 25.0, higher LNs retrieval and less vascular injury were still present in the CTA group, which was of vital importance in clinical practice. Furthermore, the CTA group displayed shorter hospital stay (LOS). Conclusion We established a new perigastric artery classification. Application of the classification can improve the short-term clinical outcomes of patients. Keywords Gastrectomy . CTA . Vascular variation . Clinical outcome
Introduction Gastric cancer is the fifth most common cancer and the third leading cause of cancer death worldwide.1 Although there are many ways to treat gastric cancer, including radiotherapy, chemotherapy and immunotherapy, surgical resection remains the only appropriate treatment option to improve the survival rate of patients with gastric This paper was presented as poster at the 13th International Gastric Cancer Congress (IGCC 2019), 8–11 May 2019 in Prague, Czech Republic. * Yanbing Zhou [email protected] 1
Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao City, Shandong Province, China
cancer.2Compared with open surgery, laparoscopic gastric surgery has equivalent oncologic outcomes, with less postoperative pain, earlier initiation of oral feeding, and earlier discharge from the hospital, and its applicati
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