A Case of Distal Gastrectomy and D2 Lymph Node Dissection with Arterial Reconstruction for Advanced Gastric Cancer after Coronary Bypass Grafting Using the Right Gastroepiploic Artery

Tomohide Takahashi, Toshihiko Kondo, Chihiro Shigematsu and Hisao Suda*

Department of Surgery, Nerima Sakuradai Clinic
Department of Cardiovascular Surgery, Kouseikai Hospital Cardiovascular Diseases Center*

We experienced distal gastrectomy with D2 lymph node dissection and arterial reconstruction between the splenic artery and an in situ right gastroepiploic artery graft for a case of advanced cancer in the lower portion of the stomach after coronary bypass grafting using the right gasroepiploic artery (RGEA) as an in situ graft. A 73-year-old man, who had undergone triple coronary artery bypass grafting 7 years previously, presented with tarry stools and was diagnosed as having advanced cancer in the antrum. He underwent the above operation and the postoperative course has been uneventful. This procedure presents merits in coronary arterial revision only in the intraabdominal approach and a precise lymph node dissection, particularly in No. 6, by ligation and division of the basis of RGEA. We consider this procedure one of the options for advanced gastric cancer after coronary bypass grafting using the RGEA. No other report like this was found in the literature, to the best of knowledge, and we report this case herein.

Key words
coronary artery bypass grafting, right gasroepiploic artery, gastric cancer

Reprint requests
Tomohide Takahashi Department of Surgery, Saga University Faculty of Medicine
5-1-1 Nabeshima, Saga, 849-8501 JAPAN

Accepted
November 30, 2005

To read the PDF file you will need Abobe Reader installed on your computer.