The significance of the aberrant left hepatic artery arising from the left gastric artery at curative gastrectomy for gastric cancer
The significance of the aberrant left hepatic artery arising from the left gastric artery at curative gastrectomy for gastric cancer
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DOI：
10.1016/j.ejso.2007.02.030
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发表时间：
2007-10-01
期刊：
影响因子：
3.8
通讯作者：
Yamaguchi, T.
中科院分区：
文献类型：
--
作者：
Shinohara, T.;Ohyama, S.;Yamaguchi, T.
背景：在食管胃手术中偶尔会遇到迷走左肝动脉（ALHA）。然而，在根治性胃切除术的胃癌，这是值得怀疑的ALHA是否需要划分，以最大限度地提高淋巴结清除率和问题需要clarification.Methods：我们遇到了50例ALHA在根治性胃切除术胃癌在1997年和2001年。结果：27例保留ALHA，23例在胃左动脉起始处离断ALHA。在ALHA分割组中，术后第1天（POD）（P = 0.0008和P = 0.0007）和术后第3天（P = 0.001和P = 0.008）的血清天冬氨酸转氨酶和丙氨酸转氨酶水平分别在统计学上显著较高。接受全胃切除术的患者在ALHA分割组中占主导地位，ALHA分割组的清扫淋巴结总数较高（P = 0.018）。然而，两组中LGA周围的清扫淋巴结和转移淋巴结总数相似（P = 0.447和P = 0. 001）。（128）分别。两组的发病率和死亡率无显著差异。总体5年生存率也compared.Conclusions：虽然需要前瞻性研究，这项研究表明，ALHA的常规部门可能并不总是需要根治性胃切除术。(C)2007爱思唯尔有限公司保留所有权利。
Background: An aberrant left hepatic artery (ALHA) is occasionally encountered during esophagogastric surgery. However, at curative gastrectomy for gastric cancer, it is questionable as to whether the ALHA need to be divided in order to maximize lymph node clearance and the issue requires clarification.Methods: We encountered 50 patients with an ALHA during curative gastrectomy for gastric cancer between 1997 and 2001. Data concerning operative feasibility, postoperative liver function and therapeutic value of nodal dissection were analyzed retrospectively.Results: For 27 patients, we preserved the ALHA, and for the remaining 23 patients, we divided the ALHA at the origin of the left gastric artery (LGA). Serum levels of aspartate aminotransferase and alanine aminotransferase were statistically significant higher on postoperative day (POD) I (P = 0.0008 and P = 0.0007), and on POD 3 (P = 0.00 1 and P = 0.008), respectively, in the ALHA-divided group. Patients who underwent a total gastrectomy predominated in the ALHA-divided group, the total number of dissected lymph nodes being higher in the ALHA-divided group (P = 0.018). However, the total numbers of dissected lymph nodes and metastatic lymph nodes around the LGA were similar in the 2 groups (P = 0.447 and P = 0. 128), respectively. No significant differences were seen between the 2 groups in morbidity and mortality. The overall 5-year survival rates were also comparable.Conclusions: Although a prospective study is required, this study suggested that routine division of the ALHA may not always be required for curative gastrectomy. (C) 2007 Elsevier Ltd. All rights reserved.