Preoperative evaluation of left gastric artery by 64-slice spiral CT angiography in gastric cancer patients / 中华普通外科杂志

ABSTRACT

ObjectiveTo delineate the anatomy of left gastric artery (LGA) by CT imaging before radical gastrectomy in gastric cancer patients to facilitate intraoperative N07 lymph node dissection.MethodsPreoperative 64 spiral CT angiography (CTA) was applied to observe the origin and course of LGA in gastric cancer patients.ResultsThere were 731 gastric cancer patients undergoing preoperative image evaluation with LGA origin identified from celiac axis in 635 cases. Among those, LGA originated respectively at the crotch of splenic artery and common hepatic artery in 176 cases, from the proximal 1/3 in 292 cases, middle 1/3 in 135 cases and distal 1/3 in 32 cases. There were 9, 28, 27, 4, 4, 1, 4 and 1 cases in whom LGA originates respectively at the angle between celiac trunk and abdominal aorta, from the abdominal aorta, arteria gastrolienalis, splenic artery, common hepatic artery, left hepatic artery, artery gastrohepatica and superior mensentaric artery. LGA has not been observed in 15 cases and the origination of LGA could not be delineated in 3 cases. ConclusionsBeing familiar with the anatomy of LGA as visualized by preoperative CTA in gastric cancer patient, facilitates lymph node dissection around the LGA and decreases iatrogenic injury to vital blood vessels.