Laparoscopic right hemicolectomy after coronary artery bypass grafting using the right gastroepiploic artery: A case report

Abstract

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. The right gastroepiploic artery (RGEA) is sometimes used for coronary artery bypass grafting (CABG) due to the high patency rate of the graft. Cases of laparoscopy-assisted colectomy (LAC) after CABG using the RGEA are extremely rare. Case Report: The patient was a 70-year-old male with ascending colon cancer. His history included myocardial infarction at the age of sixty-two, for which he underwent CABG using the RGEA. The patency of the bypass vessels was good in preoperative coronary angiography and celiac angiography. Laparoscopy-assisted colectomy was conducted with standby of a cardiovascular surgeon. Pneumoperitoneum was performed at lower pressure than usual and a beating RGEA was confirmed. We were careful to avoid stress and damage to the RGEA. Laparoscopic right hemicolectomy was conducted without arrhythmia or ST change in an intraoperative electrocardiogram. Conclusion:The important thing in LAC after CABG using the RGEA seemed to be a lower pneumoperitoneum pressure, a patient position, sophisticated surgical technique, and understanding surgical anatomy to conserve the RGEA.

Surgical management of right hepatectomy after coronary artery bypass grafting using the right gastroepiploic artery: a case report and literature review

“…Sakamoto et al reported that in laparoscopic cholecystectomy, during dissection of Calot's triangle, it is necessary to ensure that the pedicle is not stretched, and it is important to use a lower pneumoperitoneal pressure (such as 5 mmHg). In laparoscopic colectomy, it has also been reported that care should be taken to avoid the possibility of unexpected excessive stress on the RGEA graft due to positional changes [8,9]. Although gastrectomy is most frequently reported, the RGEA graft may be resected, and a replacement graft may be used from the viewpoint of the lymph node dissection.…”