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Case Report
 
Laparoscopic right hemicolectomy after coronary artery bypass grafting using the right gastroepiploic artery: A case report
Makoto Takahashi1, Jun Aoki2, Yu Okazawa2, Yukihiro Yaginuma2, Yutaka Kojima3, Kazuhiro Sakamoto4
1PhD, Assistant Professor, Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
2MD, Research Associate, Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
3PhD, Associate Professor, Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
4PhD, Professor, Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.

doi:10.5348/ijcri-2014100-CR-10411

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Email: mktakaha@juntendo.ac.jp

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How to cite this article
Takahashi M, Aoki J, Okazawa Y, Yaginuma Y, Kojima Y, Sakamoto K. Laparoscopic right hemicolectomy after coronary artery bypass grafting using the right gastroepiploic artery: A case report. Int J Case Rep Images 2014;5(8):567–571.


Abstract
Introduction: 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.

Keywords: Laparoscopy assisted colectomy, Coronary artery bypass graft, Right gastroepiploic artery (RGEA), Colorectal cancer


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Author Contributions
Makoto Takahashi – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Jun Aoki – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Yu Okazawa – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Yukihiro Yaginuma – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Yutaka Kojima – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Kazuhiro Sakamoto – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2014 Makoto Takahashi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.