CAJ | 학술논문

目的术前了解胃癌患者胃左动脉的解剖,指导术中N07组淋巴结的清扫.方法利用64排螺旋CT三维血管重建技术在术前检查胃癌患者胃左动脉的起始位置.结果本组共观察731例.胃左动脉起于腹腔动脉干者635例,其中起于肝总动脉和脾动脉分支处者176例,起于腹腔干前1/3者292例,起于中1/3者135例,起于后1/3者32例.起于其他地方者共78例,其中起于腹腔干与腹主动脉夹角处者9例,起于腹主动脉者28例,起于胃脾动脉干者27例,起于脾动脉者4例,起于肝总动脉者4例,起于肝左动脉者1例,起于肝胃动脉干者4例,起于肠系膜上动脉者1例.15例胃左动脉缺如.3例特殊变异.结论术前掌握胃癌患者胃左动脉起始位置及变异情况对顺利清扫其周围淋巴结,避免血管损伤有重要意义.
목적 술전료해위암환자위좌동맥적해부,지도술중N07조림파결적청소.방법 이용64배라선CT삼유혈관중건기술재술전검사위암환자위좌동맥적기시위치.결과 본조공관찰731례.위좌동맥기우복강동맥간자635례,기중기우간총동맥화비동맥분지처자176례,기우복강간전1/3자292례,기우중1/3자135례,기우후1/3자32례.기우기타지방자공78례,기중기우복강간여복주동맥협각처자9례,기우복주동맥자28례,기우위비동맥간자27례,기우비동맥자4례,기우간총동맥자4례,기우간좌동맥자1례,기우간위동맥간자4례,기우장계막상동맥자1례.15례위좌동맥결여.3례특수변이.결론 술전장악위암환자위좌동맥기시위치급변이정황대순리청소기주위림파결,피면혈관손상유중요의의.
Objective To delineate the anatomy of left gastric artery (LGA) by CT imaging before radical gastrectomy in gastric cancer patients to facilitate intraoperative N07 lymph node dissection.Methods Preoperative 64 spiral CT angiography (CTA) was applied to observe the origin and course of LGA in gastric cancer patients. Results There were 731 gastric cancer patients undergoing preoperative image evaluation with LGA origin identified from celiac axis in 635 cases. Among those, LGA originated respectively at the crotch of splenic artery and common hepatic artery in 176 cases, from the proximal 1/3 in 292 cases, middle 1/3 in 135 cases and distal 1/3 in 32 cases. There were 9, 28, 27, 4, 4, 1, 4 and 1 cases in whom LGA originates respectively at the angle between celiac trunk and abdominal aorta, from the abdominal aorta, arteria gastrolienalis, splenic artery, common hepatic artery, left hepatic artery, artery gastrohepatica and superior mensentaric artery. LGA has not been observed in 15 cases and the origination of LGA could not be delineated in 3 cases. Conclusions Being familiar with the anatomy of LGA as visualized by preoperative CTA in gastric cancer patient, facilitates lymph node dissection around the LGA and decreases iatrogenic injury to vital blood vessels.