Total gastrectomy in a patient with an in situ right gastroepiploic artery graft.

A 60-year-old man in whom coronary artery bypass grafting was performed with an in situ right gastroepiploic artery presented with a gastric adenocarcinoma 22 months after myocardial revascularization. He underwent a total gastrectomy with preservation of the patent right gastroepiploic artery graft to the right coronary artery. Because of the difficulty of abdominal reoperations in patients with in situ right gastroepiploic artery grafts, surgeons must consider right gastroepiploic artery free graft or alternative conduits.