title: Lymphadenectomy along the infrapyloric artery may be dispensable when performing pylorus-preserving gastrectomy for early middle-third gastric cancer.
abstract: This study investigated the incidence of gastric cancer metastasis to the lymph nodes along the infrapyloric artery (IPA), namely no. 6i, by reviewing our medical records of 348 patients who underwent complete no. 6 dissection. Metastasis to these nodes was observed in 11 (3.2 %) patients. In these patients, one huge tumor was located in the middle third and ten including two early tumors were located in the lower third; the metastasis rate in early lower-third tumors was 2.1 % and reached 19.5 % in advanced tumors. In contrast, no early middle-third gastric cancers had no. 6i metastasis. The median diameter of 6i-positive tumors was 62 (range 18-115) mm, and the distance from the distal tumor border to the pyloric ring was no more than 44 mm. Lymphadenectomy along the IPA is important for treating gastric cancer invading the antrum, but may be dispensable when performing pylorus-preserving gastrectomy for early middle-third cancer.
authors: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
authors: Aya
authors: A
authors: Mizuno
authors: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan. shinosug@kuhp.kyoto-u.ac.jp.|Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. shinosug@kuhp.kyoto-u.ac.jp.
authors: Hisashi
authors: http://orcid.org/0000-0002-1397-8046
authors: H
authors: Shinohara
authors: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
authors: Shusuke
authors: S
authors: Haruta
authors: Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors: Shigeru
authors: S
authors: Tsunoda
authors: Department of Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.
authors: Yasunori
authors: Y
authors: Kurahashi
authors: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
authors: Yu
authors: Y
authors: Ohkura
authors: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
authors: Harushi
authors: H
authors: Udagawa
authors: Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors: Yoshiharu
authors: Y
authors: Sakai
mesh_terms: D001158:Arteries / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D059351:Organ Sparing Treatments / Q000379:methods; D011708:Pylorus / Q000098:blood supply / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Gastric cancer; Infrapyloric artery; Infrapyloric lymph nodes; Lymphadenectomy; Pylorus-preserving gastrectomy