Preoperative imaging of surrounding arteries by three-dimensional CT: is it useful for laparoscopic gastrectomy?
One of the difficulties in laparoscopic gastrectomy is the identification of the feeding artery of the stomach. Recently, 3-dimensional computed tomographic angiography has enabled the noninvasive visualization of arteries surrounding the stomach. Preoperative 3-dimensional computed tomographic angiography may facilitate laparoscopic gastrectomy by obtaining a road map of the arteries of the stomach. Twenty-nine cases of gastric cancer were evaluated using 3-dimensional computed tomographic angiography before surgery. Three-dimensional computed tomographic angiography showed the left gastric artery in 29 patients (100%), the right gastroepiploic artery in 29 patients (100%), the right gastric artery in 24 patients (82.8%), and the left gastroepiploic artery in 21 patients (72.4%). The aberrant hepatic artery was detected in 6 patients, and the variant of the right gastric artery and the variant of the left gastric artery were detected in 5 cases and 1 case, respectively. All laparoscopic gastrectomy procedures were performed successfully without conversion to open surgery. Preoperative 3-dimensional computed tomographic angiography was considered to be useful for laparoscopic gastrectomy.
Usui
Shinsuke
S
Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan. cdd40470@hkg.odn.ne.jp
Hiranuma
Susumu
S
Ichikawa
Tamaki
T
Maeda
Manabu
M
Kudo
Shin-Ei
SE
Iwai
Takehisa
T
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000368:Aged; D000792:Angiography; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D024405:Gastroepiploic Artery; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed