Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2019; 11(6): 499-508
Published online Jun 15, 2019. doi: 10.4251/wjgo.v11.i6.499
Relationship between celiac artery variation and number of lymph nodes dissection in gastric cancer surgery
Guang-Chuan Mu, Yuan Huang, Zhi-Ming Liu, Zhi-Bai Chen, Xiang-Hua Wu, Xin-Gan Qin, Yan-Jun Zeng
Guang-Chuan Mu, Yuan Huang, Zhi-Bai Chen, Xiang-Hua Wu, Xin-Gan Qin, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Zhi-Ming Liu, Department of General Surgery, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530000, Guangxi Zhuang Autonomous Region, China
Yan-Jun Zeng, Biomechanics and Medical Information Institute, Beijing University of Technology, Beijing 100124, China
Author contributions: Huang Y designed this study; Liu ZM, Wu XH, Qin XG, Chen ZB, and Zeng YJ conducted the study; Huang Y, Mu GC, and Chen ZB collected the data; Mu GC and Chen ZB interpreted the results; Mu GC and Huang Y drafted the article; Liu ZM revised the paper; All authors are in agreement with the content of the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Guangxi Medical University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Open-Access: This article is an open-access article thatwas selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yuan Huang, MD, Professor, Surgeon, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Street, Nanning 530021, Guangxi Zhuang Autonomous Region, China. huangyuan_09@163.com
Telephone: +86-771-5356701 Fax:+86-771-5356559
Received: January 9, 2019
Peer-review started: January 9, 2019
First decision: January 18, 2019
Revised: February 27, 2019
Accepted: March 12, 2019
Article in press: March 13, 2019
Published online: June 15, 2019
Processing time: 157 Days and 1.5 Hours
ARTICLE HIGHLIGHTS
Research background

The number of lymph nodes dissection directly affects the prognosis and recurrence of gastric cancer. In addition, celiac artery variation is quite common clinically. However, there are few studies that discuss the relationship between celiac artery variation and the number of lymph nodes dissection in gastric cancer surgery.

Research motivation

According to our previous study, the number of lymph nodes dissection in gastric cancer surgery might be different between variant celiac artery patients and normal celiac artery patients. Therefore, we conducted this study to investigate the relationship between celiac artery variation and the number of lymph nodes dissection in gastric cancer surgery.

Research objectives

To investigate the relationship between celiac artery variation and the number of lymph nodes dissection in radical D2 lymphadenectomy of gastric cancer and the effect on prognosis.

Research methods

The clinicopathological data of 421 patients treated with radical D2 lymphadenectomy were analyzed retrospectively. The difference in the number of lymph nodes dissection between celiac artery variation group and normal vessels group and the relationship with prognosis were analyzed.

Research results

The number of lymph nodes dissection in patients with celiac artery variation was significantly less than that of non-variant groups, but there was no significant difference in survival time between the two groups. Univariate and multiple Cox regression analysis showed that celiac artery variation was not a prognostic factor for gastric cancer.

Research conclusions

Celiac artery variation is an important factor affecting lymph node clearance in patients with gastric cancer. The number of lymph nodes dissection in patients with celiac artery variation is reduced, but there is no obvious effect on the prognosis. Therefore, lymph nodes around the abnormal artery, especially for the abnormal hepatic artery derived from superior mesenteric artery, may not need to be dissected in radical D2 lymphadenectomy.

Research prospective

As this was a small-scale study, we propose future studies with a larger sample sizes. At the same time, the relationship between celiac artery variation and the number of lymph nodes dissection in different celiac artery variation types should be evaluated. We propose that lymph nodes around the abnormal artery, especially for the abnormal hepatic artery derived from superior mesenteric artery, do not need to dissected in radical D2 lymphadenectomy. However, further prospective and controlled studies are required to verify this theory.