J.Jpn. Surg. Soc.. 82(5): 461-468, 1981

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Original article

THE ROLE OF PREOPERATIVE ANGIOGRAPHY IN GASTRIC CANCER

Celiac, left gastric and common hepatic angiography have been performed in 182 preoperative patients with gastric cancer. The tumor vessel or tumor stain has been identified in 176 patients (96.7%). These patients were classified into three groups: left side, right side and bilateral, according to the origin of feeding arteries of cancer. Extension of the lymphnode metastasis in each of the three angiographic groups has been compared.
1) The cancers fed by the left gastric, short gastric and left gastroepiploic arteries are classified as the left side group. Since the lymphnode metastasis has been found limited to the attendant nodes of the celiac axis and its branches in this group (N₂), the Appleby's total gastrectomy seems indicated to this group.
2) The cancers fed by the right gastric, gastroduodenal and right gastroepiploic arteries are classified as the right side group. In addition to extent mentioned above, metastasis into lymphnodes along the proper hepatic artery, behind the surface of head of pancreas or around the superior mesenteric artery has been found in 15.1 % of this group. Extended lymphnode dissection should be applied to this group (R₃).
3) The cancers fed by arteries of both avove two groups, are classified as the bilateral group. Because of extensive lymphnode metastasis, Radical operative approach to this group is by no means curative.

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