The Short-Term Outcomes of Gastric Cancer Patients Based on a Proposal for a Novel Classification of Perigastric Arteries

• Published in: Journal of gastrointestinal surgery Vol. 24; no. 11; pp. 2471 - 2481
• Main Authors: Shen, Shuai, Cao, Shougen, Jiang, Haitao, Liu, Shanglong, Liu, Xiaodong, Li, Zequn, Liu, Dan, Zhou, Yanbing
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.11.2020; Springer Nature B.V
• Subjects: Celiac Artery - diagnostic imaging; Celiac Artery - surgery; Classification; Clinical outcomes; Computed Tomography Angiography; Gastric cancer; Gastroenterology; Hepatic Artery - diagnostic imaging; Humans; Medicine; Medicine & Public Health; Original Article; Retrospective Studies; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - surgery; Surgery; Veins & arteries; Vascular variation; CTA; Clinical outcome; Gastrectomy
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-019-04427-2

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.