J.Jpn. Surg. Soc.. 96(2): 80-87, 1995

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Original article

STUDY ON FEEDING ARTERIES AND LYMPHATIC DRAINAGE OF REMNANT STOMACH CNACER USING ANGIOGRAPHY AND FINE ACTIVATED CARBON PARTICLES

Preoperative angiography was performed on 29 patients with remnant stomach cancer, The tumor vessels of the remnant stomach cancer were angiographically identified in 25 patients whose left gastric artery had been left intact (11 cases) or removed (14 cases) in their last operation. Lymph node metastases were examined in relation to the tumor vessels in 96 cases of initial cancer in the upper third of the stomach. Fine activated carbon particles (CH40) were endoscopically injected into the submucosal layer of the stomach in 13 patients with remnant stomach cnacer two days before their operation. Blackening of the lumph nodes by CH40 was observed and the effect of removing the left gastric artery on lymphatic drainage was analyzed. Findings from these studies are summarized as follows:
In cases of remnant stomach cancer where the left gastric artery was left intact, the tumor vessels most often included the left gastric artery and lymphatic drainage procceded mainly through the left gastric artery and branches of the splenic artery (the posterior gastric artery, the left gastroepiploic artery, and the short gastric artery) to the para-aortic Iymph nodes. In cases where the left gastric artery was removed, the tumor vessels were made up of branches of the splenic artery and lymphatic drainage was mainly through branches of the splenic artery to the para-aortic lymph nodes.

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