Efficacy of Preoperative Evaluation with 3-Dimensional Computed Tomography in Laparoscopic Gastrectomy

Abstract

Purpose : Diagnosis of the presence of local gastric carcinoma and determination of the appropriate method of gastric resection during laparoscopic surgery is difficult. Thus, we examined the efficacy of preoperative three-dimensional computed tomography (3D-CT) in laparoscopic gastrectomy. Method : Using an endoscope, we marked the lesion with a clip, photographed the arterial and portal venous aspects every 0.5 mm, and then created a 3D-CT image. Results : The 3D-CT image showed the presence of local stomach cancer, including its position in relation to circumferential blood vessels. It also revealed lymph nodes greater than 5 mm. Furthermore, it was possible to decide the surgical procedure (distal gastrectomy or pylorus-preserving gastrectomy) based on the 3D-CT image information. Conclusion : Preoperative planning, including determination of the appropriate surgical procedure (stomach excision range and lymph node dissection range) on the basis of 3D-CT image information, contributed greatly to successful surgery.