Skip to main content
SpringerLink
Log in

Vascular anatomy of the stomach related to resection procedures strategy

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

This study is focused on the vascular anatomy of the stomach in relation to the gastric pull-up construction. The vascular anatomy was studied on forty-one human specimens. We find out the differences in blood supplement between anterior and posterior wall. It was maked an review of the main trunk arteries of the stomach. To display the vessels of the stomach we used diaphanoscopy, digital shooting in special mode and micro preparation of the vessels. We find out that left gastric artery gives more branches to the posterior wall and right gastroepiploic artery (RGEA) gives more branches to the anterior wall. But brunches of RGEA are longer on the posterior wall than on the anterior. Also we are offering the new classification of the RGEA related to gastric pull-up construction. This classification based not only on the anatomical shapes of RGEA but on the properties of the flow dynamics through the artery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

Abbreviations

CMOS*:

Complementary Metal–Oxide–Semiconductor čip (technology is used in several analog circuits such as image sensors, also used in photography)

ISO**:

Sensitivity of the image sensor

References

  1. Berney CR (2015) Laparoscopic resection of locally advanced gastrointestinal stromal tumour (GIST) of the stomach following neoadjuvant imatinib chemoreduction. Int J Surg Case Rep 8C:103–106

    Article  PubMed  Google Scholar 

  2. Berrisford RG, Veeramootoo D, Parameswaran R, Krishnadas R, Wajed SA (2009) Laparoscopic ischemic conditioning of the stomach may reduce gastric-conduit morbidity following total minimally invasive oesophagectomy. Eur J Cardiothorac Surg 36(5):888–893

    Article  PubMed  Google Scholar 

  3. Bilal A, Baseer A, Ahmad M, Imran M, Abid M, Kalimullah M (2010) Early results of oesophagectomy for carcinoma oesophagus in 1008 cases. J Ayub Med Coll Abbottabad 22(4):109–114

    CAS  PubMed  Google Scholar 

  4. Boyle NH, Pearce A, Hunter D, Owen WJ, Mason RC (1999) Intraoperative scanning laser Doppler flowmetry in the assessment of gastric tube perfusion during esophageal resection. J Am Coll Surg 188(5):498–502

    Article  CAS  PubMed  Google Scholar 

  5. Briel JW, Tamhankar AP, Hagen JA, DeMeester SR, Johansson J, Choustoulakis E, Peters JH, Bremner CG, DeMeester TR (2004) Prevalence and risk factors for ischemia, leak, and stricture of esophageal anastomosis: gastric pull-up versus colon interposition. J Am Coll Surg 198(4):536–541 (discussion 541-2)

    Article  PubMed  Google Scholar 

  6. Buunen M, Rooijens PP, Smaal HJ, Kleinrensink GJ, van der Harst E, Tilanus HW, Lange JF (2008) Vascular anatomy of the stomach related to gastric tube construction. Dis Esophagus 21(3):272–274

    Article  CAS  PubMed  Google Scholar 

  7. Cassivi SD (2004) Leaks, strictures, and necrosis: a review of anastomotic complications following esophagectomy. Semin Thorac Cardiovasc Surg 16(2):124–132

    Article  PubMed  Google Scholar 

  8. Fujimura T, Kinoshita J, Makino I, Nakamural K, Oyama K, Fujita H, Tajima H, Takamura H, Ninomiya I, Kitagawa H, Fushida S, Ohta T, Miwa K (2012) Gastric cancer—state of the art in Japan. Rozhl Chir 91(6):346–352

    CAS  PubMed  Google Scholar 

  9. Gayretli Ö, Kocabiyik N, Kale AC, Yalcin B, Ozan H (2010) Multivariations of the left gastric artery: a case report. Trakya Univ Tip Fak Derg 27(4):420–423

    Google Scholar 

  10. Guadagni S, Gola P, Marsili L, Catarci M, Mancini E, Agnifili A, De Bernardinis G, Sano T, Maruyama K (1995) Arterial vasculature of the stomach and oncologic gastrectomies. Surg Radiol Anat 17(3):269–276

    Article  CAS  PubMed  Google Scholar 

  11. Hölscher AH, Schneider PM, Gutschow C, Schröder W (2007) Laparoscopic ischemic conditioning of the stomach for esophageal replacement. Ann Surg 245(2):241–246

    Article  PubMed  PubMed Central  Google Scholar 

  12. Koskas F, Gayet B (1985) Anatomical study of retrosternal gastric esophagoplasties. Anat Clin 7(4):237–256

    Article  CAS  PubMed  Google Scholar 

  13. Ishigami K, Yoshimitsu K, Irie H, Tajima T, Asayama Y, Hirakawa M, Honda H (2006) Accessory left gastric artery from left hepatic artery shown on MDCT and conventional angiography: correlation with CT hepatic arteriography. AJR Am J Roentgenol 187(4):1002–1009

    Article  PubMed  Google Scholar 

  14. Lerut T, Coosemans W, Decker G, De Leyn P, Nafteux P, van Raemdonck D (2002) Anastomotic complications after esophagectomy. Dig Surg 19(2):92–98

    Article  CAS  PubMed  Google Scholar 

  15. Liebermann-Meffert DM, Meier R, Siewert JR (1992) Vascular anatomy of the gastric tube used for esophageal reconstruction. Ann Thorac Surg 54(6):1110–1115

    Article  CAS  PubMed  Google Scholar 

  16. Matsuki M, Kani H, Tatsugami F, Yoshikawa S, Narabayashi I, Lee SW, Shinohara H, Nomura E, Tanigawa N (2004) Preoperative assessment of vascular anatomy around the stomach by 3D imaging using MDCT before laparoscopy-assisted gastrectomy. AJR Am J Roentgenol 183(1):145–151

    Article  PubMed  Google Scholar 

  17. Matsuki M, Tanikake M, Kani H, Tatsugami F, Kanazawa S, Kanamoto T, Inada Y, Yoshikawa S, Narabayashi I, Lee SW, Nomura E, Okuda J, Tanigawa N (2006) Dual-phase 3D CT angiography during a single breath-hold using 16-MDCT: assessment of vascular anatomy before laparoscopic gastrectomy. AJR Am J Roentgenol 186(4):1079–1085

    Article  PubMed  Google Scholar 

  18. Meyerson SL, Mehta CK (2014) Managing complications II: conduit failure and conduit airway fistulas. J Thorac Dis 6(Suppl 3):S364–S371

    PubMed  PubMed Central  Google Scholar 

  19. Mittermair C, Klaus A, Scheidl S, Maglione M, Hermann M, Margreiter R, Nguyen N, Weiss H (2008) Functional capillary density in ischemic conditioning:implications for esophageal resection with the gastric conduit. Am J Surg 196(1):88–92

    Article  PubMed  Google Scholar 

  20. Ndoye JM, Dia A, Ndiaye A, Fall B, Diop M, Ndiaye A, Sow ML (2006) Arteriography of three models of gastric oesophagoplasty: the whole stomach, a wide gastric tube and a narrow gastric tube. Surg Radiol Anat 28(5):429–437

    Article  PubMed  Google Scholar 

  21. Ohgiya Y, Gokan T, Munechika H (1999) Demonstration of aberrant hepatic and gastric arteries with helical CT. Invest Radiol 34(9):579–584

    Article  CAS  PubMed  Google Scholar 

  22. Rached AA, Basile M, El Masri H (2014) Gastric leaks post sleeve gastrectomy: review of its prevention and management. World J Gastroenterol 20(38):13904–13910

    Article  PubMed  PubMed Central  Google Scholar 

  23. Rajabi Mashhadi MT, Maddah Gh, Bagheri R, Faghanzadeh Ganji GH, Shojaeian R, Nurshafiee S, Salehi M, Gharib M (2014) The comparison of the complications between two surgical techniques of esophageal cancer. J Cardiothorac Med 2(2):177–180

    Google Scholar 

  24. Reavis MK (2009) The esophageal anastomosis: how improving blood supply affects leak rate. J Gastrointest Surg 13(9):1558–1560

    Article  PubMed  PubMed Central  Google Scholar 

  25. Schilling MK, Mettler D, Redaelli C, Büchler MW (1997) Circulatory and anatomic differences among experimental gastric tubes as esophageal replacement. World J Surg 21(9):992–997

    Article  CAS  PubMed  Google Scholar 

  26. Schröder W, Stippel D, Gutschow C, Leers J, Hölscher AH (2004) Postoperative recovery of microcirculation after gastric tube formation. Langenbecks Arch Surg 389(4):267–271

    Article  PubMed  Google Scholar 

  27. Shen Y, Wang H, Feng M, Tan L, Wang Q (2014) The effect of narrowed gastric conduits on anastomotic leakage following minimally invasive oesophagectomy. Interact Cardiovasc Thorac Surg 19(2):263–268

    Article  PubMed  Google Scholar 

  28. Veeramootoo D, Parameswaran R, Krishnadas R, Froeschle P, Cooper M, Berrisford RG, Wajed SA (2009) Classification and early recognition of gastric conduit failure after minimally invasive esophagectomy. Surg Endosc 23(9):2110–2116

    Article  PubMed  Google Scholar 

  29. Veeramootoo D, Shore AC, Shields B, Krishnadas R, Cooper M, Berrisford RG, Wajed SA (2010) Ischemic conditioning shows a time-dependant influence on the fate of the gastric conduit after minimally invasive esophagectomy. Surg Endosc 24(5):1126–1131

    Article  PubMed  Google Scholar 

  30. Viklund P, Lindblad M, Lu M, Ye W, Johansson J, Lagergem J (2006) Risk factors for complications after esophageal cancer resection: a prospective population-based study in Sweden. Ann Surg 243(2):204–211

    Article  PubMed  PubMed Central  Google Scholar 

  31. Walther B, Johansson J, Johnsson F, Von Holstein CS, Zilling T (2003) Cervical or thoracic anastomosis after esophageal resection and gastric tube reconstruction: a prospective randomized trail comparing sutured neck anastomosis with stapled intrathoracic anastomosis. Ann Surg 238(6):803–812

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 1st Surgical Department, St. Anne´s University Hospital, Pekarska 53, 602 00, Brno, Czech Republic

    V. Prudius

  2. Surgical Department, The University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic

    V. Procházka & Z. Kala

  3. Institute of Pathology, The University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic

    Z. Pavlovský

  4. Clinical Department of Internal Medicine, Geriatrics and General Medicine, Jihlavská 20, 625 00, Brno, Czech Republic

    D. Prudius

Authors
  1. V. Prudius
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Procházka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Z. Pavlovský
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. Prudius
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Z. Kala
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to V. Prudius.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Prudius, V., Procházka, V., Pavlovský, Z. et al. Vascular anatomy of the stomach related to resection procedures strategy. Surg Radiol Anat 39, 433–440 (2017). https://doi.org/10.1007/s00276-016-1746-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-016-1746-2

Keywords

Search

Navigation