title: Three-dimensional fusion images combining CT gastrography and CT angiography for early gastric cancer: pilot experiences of preoperative simulation prior to totally laparoscopic gastrectomy.
abstract: We herein report two cases of gastric cancer in which preoperative 3-D CT gastrography and CT angiography fusion images enabled totally laparoscopic gastrectomy. Case 1 involved a 60-year-old woman with a superficial depressed lesion on the greater curvature of the middle gastric body. Case 2 involved a 64-year-old woman with a superficial depressed lesion on the posterior wall of the upper gastric body. In both cases, 3-D fusion images were prepared from enhanced CT scans after the area near the lesions was clipped under preoperative gastroendoscopy. Based on the relative position between the clips and nearby vessels, a resection line was preoperatively determined in each case. Totally laparoscopic distal gastrectomy and totally laparoscopic proximal gastrectomy were performed in cases 1 and 2, respectively, with safe surgical margins. Three-dimensional fusion images can help in preoperative simulation of totally laparoscopic gastrectomy.
authors.affiliation: Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hiramatsu
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Ichirota
authors.initials: I
authors.lastname: Iino
authors.forename: Manabu
authors.initials: M
authors.lastname: Ohta
authors.forename: Kinji
authors.initials: K
authors.lastname: Kamiya
authors.forename: Takanori
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Unno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konno
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D000792:Angiography / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D010535:Laparoscopy; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D010865:Pilot Projects; D011300:Preoperative Care / Q000379:methods; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Computed tomographic gastrography; gastric cancer; totally laparoscopic gastrectomy