第13巻 2017年2月　第1号

■症例報告

右胃大網動脈を用いた冠動脈バイパス術後の胃癌に対し胃切除術を施行した3例
安藤　文彦¹, 金沢　義一¹, 藤田　逸郎¹, 柿沼　大輔¹, 菅野　仁士¹, 萩原　信敏¹, 松谷　毅¹, 野村　務¹, 塩田　吉宣², 内田　英二^1
1日本医科大学付属病院消化器外科
²塩田病院

Gastrectomy to Treat Gastric Cancer Occurring after Coronary Artery Bypass Graft with the Right Gastroepiploic Artery - A Study of Three Cases
Fumihiko Ando¹, Yoshikazu Kanazawa¹, Itsuo Fujita¹, Daisuke Kakinuma¹, Hitoshi Kanno¹, Nobutoshi Hagiwara¹, Takeshi Matsutani¹, Tsutomu Nomura¹, Yoshinobu Shioda² and Eiji Uchida^1
1)Department of Surgery, Nippon Medical School
²⁾Shioda Hospital

There is no established surgical strategy to manage dissection of the infrapyloric lymph node in cases of gastric cancer occurring after a coronary artery bypass graft (CABG) with the right gastroepiploic artery (RGEA). We performed gastrectomy in three patients with gastric cancer who had undergone CABG using RGEA. In order to reduce the preoperative risk, we dissected the infrapyloric lymph node by skeletonizing the RGEA bypass graft without redoing the CABG. No recurrence of the disease has been observed in any of the three patients. It is important to implement a non-invasive surgical strategy for gastric cancer patients at high risk due to severe heart disease or advanced age. This gastrectomy procedure is an adequate noninvasive surgical strategy, because it enables a complete cure without coronary revascularization.

日医大医会誌 2017; 13(1), 42-47

Key words
coronary artery bypass graft, right gastroepiploic artery, gastric cancer

Correspondence to
Fumihiko Ando, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku Tokyo 113-8603, Japan
E-mail：ando-f@nms.ac.jp

受付：2016年11月8日　受理：2016年12月19日