[Curative gastrectomy with reconstruction of a right gastroepiploic artery graft]

We report a case of a 66-year-old man who developed gastric cancer 5 years after coronary artery bypass grafting using right gastroepiploic artery graft (RGEA). Some authors reported successful gastrectomy preserving a functional RGEA, but it carries the risk of injury of the graft or graft spasm. Preoperatively, catheter intervention for target vessels of RGEA (right coronary artery: RCA) was tried but failed. We performed re-do coronary artery bypass grafting (CABG) via right thoracotomy with right internal thoracic artery (RITA)-radial artery (RA) composite graft. The composite graft was drawn into the peritoneal cavity through the diaphragm, and anastomosed to the RGEA on the anterior plane of the liver. After that, partial gastrectomy was performed with resection of the RGEA and dissection of the #6 lymph nodes. We consider this method is safe to treat such cases.