Perigastric Arterial Variations And Their Significance In Radical Gastrectomy In Gastric Cancer

Objective：To make certain and optimize the classification of the Perigastric arterialvariations and to explore their significance during and after the resection so as to radicallyresect the gastric cancer which is based on the patient individually.Methods：It was a retrospective study. Clinical data of699patients with gastriccancer who were clearly diagnosed in the second affiliated hospital of Soochow university,and underwent radical gastrectomy in January2010to June2014. All patients wereexamined by multi-detector computed tomography (MDCT) to evaluate the tumors andtheir relationship with peripheral vascular structures which contained perigastric arterialvariations. Some clinic detections were taken into retrospectively contrary such as CEA,AFP, CA199and AST, ALT, TBIL, DBIL before and after surgery. The days ofhospitalization were also included. SPSS18.0was for the data statistics.Results:1.15types arterial variations were discovered, which including some typicaltypes just as HGSptrunk+SMA+ALHA(108cases), HGSptrunk+SMA+ARHA(11cases),HGSp trunk+SMA+ALHA+ARHA(6cases) and so on;but also containing some rarelyreported types as HSp trunk+SMA&LGA（-）（3cases）,H2GSp trunk+SMA（,1cases）,HGSp2trunk+SMA（1cases）,which should be supplement to the used perigastric arterialvariations classification.2. Of the117patients,(16.74%) had an ALHA and554(79.26%) did not exist any perigastric arterial variations. So two groups had ALHA ornot, were used for comparison. There were no significant differences in intraoperativecharacteristics, postoperative recovery, and CEA, AFP, CA199, TBIL, DBIL (P＞0.05each), While ALT and AST activities were higher in the ALHA than in the non-ALHAgroup on days1,4,7(P＜0.05).Conclusion:1. ALHA is a common anomaly that was found in16.74%of patients, ifsevered during the surgery, which might cause liver enzymes elevated. It can be safeduring radical gastrectomy in patients without CLD, but should be left intact in patients with CLD to prevent liver dysfunction, especially in early-stage gastric cancer patients.2.15types arterial variations were discovered, some rarely reported types as HSptrunk+SMA&LGA（-）,H2GSp trunk+SMA, HGSp2trunk+SMA, which should besupplement to the used Perigastric arterial variations classification and serve for individualradical gastrectomy.