A Case of Essential Thrombocythemia with Gastric Cancer treated by Laparoscopic assisted Total Gastrectomy

Kozo Yoshikawa, Mitsuo Shimada, Nobuhiro Kurita, Takashi Iwata, Masanori Nishioka, Jun Higashijima, Tomohiko Miyatani, Motoya Chikakiyo, Toshihiro Nakao and Masato Komatsu

Department of Surgery, The University of Tokushima

Essential thrombocythemia (ET) is rare and characterized by persistant thrombocytosis, necessitating measures to prevent thrombotic complications We report a case of essential ET with gastric cancer. A 77-year-old man with ET was treated with aspirin and hydroxycarbamide for 8 years experienced epigastralgia, found in gastrointestinal fiberscopy to be early gastric cancer in the U region. Upon admission, we changed his therapeutic ET regimen from aspirin to heparin and postponed hydroxycarbamide from 2 days preoperatively before laparoscopy-assisted total gastrectomy. Heparin was resumed on postoperative day (POD) 2 and aspirin on POD 5. Because his platelet count exceeded 70×10⁴/μl, we resumed hydroxycarbamide on POD 12. No ET-related complication occurred. Adequate platelet count control and anticoagulant therapy through the perioperative period are very important for surgical patients with ET. In so far as we know, no gastrointestinal cancer patients with ET have been treated by laparoscopic surgery.

Key words
Essential thrombocythemia, hydroxycarbamide, gastric cancer

Reprint requests
Kozo Yoshikawa Department of Surgery, The University of Tokushima
3-18-15 Kuramoto-cho, Tokushima, 770-8503 JAPAN

Accepted
October 22, 2008

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