{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T22:49:35Z","timestamp":1780440575893,"version":"3.54.1"},"reference-count":21,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Patient-Centered Clinical Research Coordinating Center (PACEN), funded by the Ministry of Health &amp; Welfare, Republic of Korea","award":["RS-2020-KH095827"],"award-info":[{"award-number":["RS-2020-KH095827"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: During laparoscopic pylorus-preserving gastrectomy (LPPG), the preservation of the infra-pyloric artery (IPA) and dissection of the infra-pyloric lymph node (LN) station 6 are essential, underscoring the importance of understanding the anatomical structure of the IPA. This study aimed to investigate anatomical variations in the IPA and surgical outcomes based on data from a multicenter prospective trial. Methods: A post hoc analysis was conducted based on the Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS)-04 trial, in which patients randomly underwent LPPG or laparoscopic distal gastrectomy (LDG). The IPA variations were categorized into three groups: distal, caudal, and proximal. Clinicopathological characteristics and surgical outcomes were analyzed according to the IPA type. Results: Among the 192 patients, the distribution of IPA types was as follows: 45 (23.44%) distal, 74 (38.54%) caudal, and 73 (38.02%) proximal. There were no significant differences in the clinicopathological characteristics between the IPA types. Of the 119 patients who underwent LPPG, a significant difference in operative time was observed based on the IPA type, with a longer duration observed with the distal type compared to that of the proximal type (distal type vs. proximal type: 202.5 (150\u2013275) vs. 170 (105\u2013265) min, p = 0.0300). No significant differences were observed in other surgical outcomes. Conclusions: The distribution of IPA types was more diverse than that reported in previous studies. There was a statistically significant difference in the operating time based on the IPA type. Identifying IPA variations during LPPG may be beneficial for gastric cancer surgeons.<\/jats:p>","DOI":"10.3390\/jcm14072508","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T10:06:28Z","timestamp":1744020388000},"page":"2508","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of Vascular Anatomic Variations in the Infra-Pyloric Area on the Surgical Outcomes of Laparoscopic Pylorus-Preserving Gastrectomy in Early Gastric Cancer: A Post Hoc Analysis of a Multicenter Prospective Trial (KLASS-04)"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6252-7532","authenticated-orcid":false,"given":"Sang Soo","family":"Eom","sequence":"first","affiliation":[{"name":"Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang 10380, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5095-203X","authenticated-orcid":false,"given":"Sin Hye","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Eunpyeong St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3347-5438","authenticated-orcid":false,"given":"Young Shick","family":"Rhee","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsanseo-gu, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sa-Hong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyuk-Joon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea"},{"name":"Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsanseo-gu, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-Kwang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea"},{"name":"Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9644-6127","authenticated-orcid":false,"given":"Do Joong","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea"},{"name":"Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"},{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5615-4162","authenticated-orcid":false,"given":"Sang Uk","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ajou University Hospital, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung-Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8593-9214","authenticated-orcid":false,"given":"Woo Jin","family":"Hyung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yonsei University Severance Hospital, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Ho","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gyeongsang National University Hospital, Daegu 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Suhk","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea"},{"name":"Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"},{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oh-Kyung","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kyungpook National University Hospital, Daegu 41566, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wook","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yeouido St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 14662, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Kyu","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery, Chonnam National University Medical School, Hwasun 58128, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Man","family":"Yoon","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsanseo-gu, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Hoon","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3929-796X","authenticated-orcid":false,"given":"Seong-Ho","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea"},{"name":"Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keun Won","family":"Ryu","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsanseo-gu, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1002\/ijc.31937","article-title":"Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods","volume":"144","author":"Ferlay","year":"2019","journal-title":"Int. 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