title: [Total Gastrectomy for Advanced Gastric Cancer after Coronary Artery Bypass Grafting Using the Right Gastroepiploic Artery: Report of a Case].
abstract: An 82-year-old man, who had undergone coronary artery bypass grafting(CABG) with the right gastroepiploic artery( RGEA) 13 years previously, suffered with abdominal pain after meal and tarry stools, and was diagnosed with advanced gastric cancer. Gastroscopy revealed an advanced Borrmann type 4 cancer at the lesser curvature of the gastric body to the pyloric ring. The gastrogram showed poor extension and stenosis at the same part. Abdominal computed tomography showed the tumor reached the subserosal layer and infrapyloric lymph nodes were swollen. Abdominal angiography showed the RGEA graft remained well patent. Total gastrectomy with D2 lymph nodes dissection and arterial reconstruction between the splenic artery and the RGEA graft was performed. He has been well without any sign of cancer recurrence since the operation. Recently, more patients with CABG using RGEA are found to have gastric cancer and require the resection of RGEA for lymph nodes dissection as this case. We consider this procedure one of the options for advanced gastric cancer after coronary bypass grafting using RGEA.
authors.affiliation: Department of General Surgery, Okitama Public General Hospital, Yamagata, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Takahashi
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kamio
authors.forename: Koichiro
authors.initials: K
authors.lastname: Ozawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Goto
authors.forename: Shigeo
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Masaomi
authors.initials: M
authors.lastname: Mizutani
authors.forename: Takayuki
authors.initials: T
authors.lastname: Higashi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Moriya
authors.forename: Moriyoshi
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Kenji
authors.initials: K
authors.lastname: Mase
authors.forename: Osamu
authors.initials: O
authors.lastname: Usuba
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D005743:Gastrectomy; D024405:Gastroepiploic Artery / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome