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Three-dimensional computed tomography analysis of the vascular anatomy of the splenic hilum for gastric cancer surgery

Three-dimensional computed tomography analysis of the vascular anatomy of the splenic hilum for... Purpose Splenic infarction may occur if the splenic branches are injured or ligated accidentally during gastrectomy. We used three-dimensional computed tomography (3D-CT) imaging to distinguish the vascular anatomy of the splenic hilum in individual patients, focusing on the splenic polar branches and the gastric branches. Methods The subjects of this study were 104 patients who underwent computed tomography (CT) with intravenous con- trast before gastrectomy. SYNAPSE 3D® (Fujifilm Medical, Tokyo, Japan) was used to generate the 3D-CT images. The total spleen volume and the area supplied by the superior polar artery (SPA) in each patient were estimated using the “liver analysis” function. Results The SPA without the gastric branch (supplying only the spleen), the SPA with the gastric branch (supplying both the stomach and the spleen), and the posterior gastric artery (supplying only the stomach) were present in 14, 45, and 18% of the patients, respectively. The SPA supplied 12% of the total spleen volume on average; however, it supplied over 30% in two patients. Conclusion We identified the vascular anatomy around the splenic hilum in over 100 patients. Based on our findings, we recommend preservation of the SPA when it is supplying a large area of the spleen. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Surgery Today Springer Journals

Three-dimensional computed tomography analysis of the vascular anatomy of the splenic hilum for gastric cancer surgery

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Nature Singapore Pte Ltd.
Subject
Medicine & Public Health; Surgery; Surgical Oncology
ISSN
0941-1291
eISSN
1436-2813
DOI
10.1007/s00595-018-1679-y
pmid
29858668
Publisher site
See Article on Publisher Site

Abstract

Purpose Splenic infarction may occur if the splenic branches are injured or ligated accidentally during gastrectomy. We used three-dimensional computed tomography (3D-CT) imaging to distinguish the vascular anatomy of the splenic hilum in individual patients, focusing on the splenic polar branches and the gastric branches. Methods The subjects of this study were 104 patients who underwent computed tomography (CT) with intravenous con- trast before gastrectomy. SYNAPSE 3D® (Fujifilm Medical, Tokyo, Japan) was used to generate the 3D-CT images. The total spleen volume and the area supplied by the superior polar artery (SPA) in each patient were estimated using the “liver analysis” function. Results The SPA without the gastric branch (supplying only the spleen), the SPA with the gastric branch (supplying both the stomach and the spleen), and the posterior gastric artery (supplying only the stomach) were present in 14, 45, and 18% of the patients, respectively. The SPA supplied 12% of the total spleen volume on average; however, it supplied over 30% in two patients. Conclusion We identified the vascular anatomy around the splenic hilum in over 100 patients. Based on our findings, we recommend preservation of the SPA when it is supplying a large area of the spleen.

Journal

Surgery Today – Springer Journals

Published: Jun 1, 2018

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