The Origin of Infrapyloric Artery

NCT03071237 — Completed, 429 participants, Peking University

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The Origin of Infrapyloric Artery: an Observational Trial

Registry	NCT03071237, acronym IPA-Origin
Status	Completed
Study type	Observational
Enrollment	429 (Actual)
Sponsor	Peking University (Other)
Conditions	Stomach Neoplasm
Interventions	Gastrectomy (Procedure)
Dates	start 2017-03-04, primary completion 2017-12-31, completion 2017-12-31, first posted 2017-03-06, last updated 2019-02-19
Locations	1 site in China

-Summary

Infrapyloric artery(IPA) is of great importance for gastric cancer patients. According to previous study, the origin of IPA varies greatly among different studies. This trial aims to tell the distribution of IPA origin in Chinese patients.

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+Detailed description

Infrapyloric artery(IPA) is of great importance for gastric cancer patients. In early gastric cancer patients, the pylorus-preserving gastrectomy requires the preserving of IPA. In advanced gastric cancer patients, the subgroup of No. 6 lymph node might be associated with IPA. In Japanese Gastric Cancer Association(JGCA) gastric cancer classification guidelines, the No. 6 lymph nodes is defined as lymph nodes along the first branch and proximal part of the right gastroepiploic artery(RGEA) down to the confluence of the right gastroepiploic vein and the anterior superior pancreatoduodenal vein. However,if IPA origins from the gastroduodenal artery(GDA) or anterior superior pancreatoduodenal artery(ASPDA), the lymph nodes along the IPA can not be grouped into the No. 6 lymph nodes. Thus, a new definition of No. 6 lymph nodes is needed on the basis of the origin of IPA.

Previous studies about IPA origin are few and the origin of IPA varies greatly among different studies.

+Arms and interventions

Arm	Type	Interventions	Description
Observational group		Procedure: Gastrectomy	Patients who would receive total gastrectomy or distal gastrectomy are enrolled in to the study and this group. An optional reconstruction of IPA by enhanced CT scan can be performed before surgery but not a definite require. During the operation, IPA origin location will be photo-taken or video-recorded before its transection.

Gastrectomy (Procedure), also known as surgery: Patients with gastric cancer that needs receiving total or distal gastrectomy. During the surgery, IPA needs to be exposed and transected.

+Outcome measures

Primary outcomes

Distribution of IPA origin [Immediately after surgery]: The percentage of IPA origin from GDA, ASPDA and RGEA.

Secondary outcomes

Reconstruction rate of IPA by CT scan [Immediately after the reconstruction of CT scan.]: The rate of identification of IPA origin by reconstruction of CT scan.

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Patients with gastric cancer who needs to receive total or distal gastrectomy.
* Signed informed consent

Exclusion Criteria:

* IPA not dissected, photo-taken or video-recorded.

+Locations (1)

Facility	City	Country	Status
Beijing Cancer Hospital	Beijing, Beijing Municipality	China

+Publications

Haruta S, Shinohara H, Ueno M, Udagawa H, Sakai Y, Uyama I. Anatomical considerations of the infrapyloric artery and its associated lymph nodes during laparoscopic gastric cancer surgery. Gastric Cancer. 2015 Oct;18(4):876-80. doi: 10.1007/s10120-014-0424-5. Epub 2014 Sep 17. PMID 25228163
Shinohara H, Kurahashi Y, Kanaya S, Haruta S, Ueno M, Udagawa H, Sakai Y. Topographic anatomy and laparoscopic technique for dissection of no. 6 infrapyloric lymph nodes in gastric cancer surgery. Gastric Cancer. 2013 Oct;16(4):615-20. doi: 10.1007/s10120-012-0229-3. Epub 2013 Jan 13. PMID 23314832
Results publication: Miao R, Qu J, Li Z, Wang D, Yu J, Zang W, Li Y, Liu F, Zhang J, Song W, Ye K, Yan S, Wang W, Ren S, Zang L, Jing C, Zhang L, Wang K, Fu W, Fan L, Liang B, Zhao G, Cai J, Yang L, Zhu J, You J, Yang K, Huang Q, Niu Z, Ning N, Qiu X, Ji G, Liang F, Huang H, Gao C, Shan F, Li S, Jia Y, Zhang L, Ying X, Zhang Y, Bu Z, Su X, Zhao G, Li Z, Ji J. Anatomical variation of infra-pyloric artery origination: A prospective multicenter observational study (IPA-Origin). Chin J Cancer Res. 2018 Oct;30(5):500-507. doi: 10.21147/j.issn.1000-9604.2018.05.03. PMID 30510361

+Investigators

Ziyu Li, M.D., Principal investigator, Gastrointestinal Cancer Center, Peking University