Laparoscopic gastrectomy for gastric cancer with two left gastric arteries: Safe and adequate lymphadenectomy in a rare arterial abnormality

Clinical studies have established the safety and advantages of laparoscopic surgery for gastric cancer; therefore, laparoscopic gastrectomy (LG) in clinical practice is increasing. We report the case of a 77‐year‐old patient with gastric cancer who was referred to our center for LG. Esophagogastrodu...

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Bibliographic Details
Published in:Asian journal of endoscopic surgery 2023-01, Vol.16 (1), p.105-109
Main Authors: Ito, Sunao, Ogawa, Ryo, Saito, Masaki, Ueno, Shuhei, Hayakawa, Shunsuke, Okubo, Tomotaka, Sagawa, Hiroyuki, Tanaka, Tatsuya, Takahashi, Hiroki, Matsuo, Yoichi, Takiguchi, Shuji
Format: Article
Language:English
Subjects:
Aged
gastrectomy
Gastrectomy - methods
Gastric Artery - pathology
Gastric cancer
Gastrointestinal surgery
Humans
Laparoscopy
Laparoscopy - methods
Lymph Node Excision - methods
lymphadenectomy
Retrospective Studies
Stomach Neoplasms - diagnostic imaging
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
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Summary:Clinical studies have established the safety and advantages of laparoscopic surgery for gastric cancer; therefore, laparoscopic gastrectomy (LG) in clinical practice is increasing. We report the case of a 77‐year‐old patient with gastric cancer who was referred to our center for LG. Esophagogastroduodenoscopy revealed a type 3 tumor identified as adenocarcinoma on biopsy. Three‐dimensional computed tomography‐angiography revealed two left gastric arteries (LGAs) branching from the celiac trunk. By laparoscopically performing the outermost layer‐oriented lymphadenectomy (OML‐OL), the two LGAs were detected and appropriately divided. Subtotal gastrectomy was completed, and the patient had an uneventful postoperative course. The OML‐OL was appropriate for LG in this situation. This case demonstrates the necessity of preoperative three‐dimensional computed tomography‐angiography with 1‐mm slices and the importance of performing OML‐OL.
ISSN:1758-5902
1758-5910
DOI:10.1111/ases.13110