3D-Imaging evaluation of double aortic arch with MSCTA: A case report and mini-review

Double aortic arch (DAA) is a rare congenital anomaly associated with the formation of a vascular ring. Patients with DAA commonly suffer from complications caused by intracardiac and extracardiac malformations and different degrees of airway stenosis. Multislice computed tomographic angiography (MSCTA) is an intuitive and effective medical imaging technique in clinical diagnosis of DAA. MSCTA can accurately manifest the aortic arch and the course of the descending aorta and airway stenosis in three-dimension (3D). It is important to diagnose and make an operative plan for DAA. In this paper, we present a case of DAA diagnosed by MSCTA with 3D-static images and rotated reconstruction images and performed a mini-review.

Study of celiac artery variations and related surgical techniques in gastric cancer

AIM: To investigate celiac artery variations in gastric cancer patients and the impact on gastric cancer surgery, and also to discuss the value of the ultrasonic knife in reducing the risk caused by celiac artery variations.

METHODS: A retrospective analysis was conducted to investigate the difference in average operation time, intraoperative blood loss, number of harvested lymph nodes, average postoperative drainage within 3 d, and postoperative hospital stay between the group with vascular variations and no vascular variations, and between the ultrasonic harmonic scalpel and conventional electric scalpel surgery group.

RESULTS: One hundred and fifty-eight cases presented with normal celiac artery, and 80 presented with celiac artery variation (33.61%). The average operation time, blood loss, average drainage within 3 d after surgery in the celiac artery variation group were significantly more than in the no celiac artery variation group (215.7 ± 32.7 min vs 204.2 ± 31.3 min, 220.0 ± 56.7 mL vs 163.1 ± 52.3 mL, 193.6 ± 41.4 mL vs 175.3 ± 34.1 mL, respectively, P < 0.05). In celiac artery variation patients, the average operation time, blood loss, average drainage within 3 d after surgery in the ultrasonic harmonic scalpel group were significantly lower than in the conventional electric scalpel surgery group (209.5 ± 34.9 min vs 226.9 ± 29.4 min, 207.5 ± 57.1 mL vs 235.6 ± 52.9 mL, 184.4 ± 38.2 mL vs 205.0 ± 42.9 mL, respectively, P < 0.05), and the number of lymph node dissections was significantly higher than in the conventional surgery group (25.5 ± 9.2 vs 19.9 ± 7.8, P < 0.05).

CONCLUSION: Celiac artery variation increases the difficulty and risk of radical gastrectomy. Preoperative imaging evaluation and the application of ultrasonic harmonic scalpel are conducive to radical gastrectomy.