2017 Volume 50 Issue 4 Pages 280-287
Leriche syndrome is a chronic abdominal aortic occlusive disease. We encountered a case of gastric cancer with Leriche syndrome, therefore we consider the case in light of the available literature. A 73-year-old man had been followed for Leriche syndrome. Due to development of anemia, he underwent upper gastrointestinal endoscopy for evaluation of the cause of anemia and was given a diagnosis of gastric cancer. The clinical stage was T4aN1M0 Stage IIIA. We carefully evaluated the surgical tolerability of the patient and performed distal gastrectomy and D2 lymphadenectomy after suspending anti-platelett therapy. Laparotomy was performed by an upper abdominal midline incision to avoid damage of collateral circulation to the lower extremities, with careful manipulation of the abdominal wall and shortening of operation time. Although the patient initially experienced wound dehiscence on post-operative day (POD) 1, the post-surgical course was favorable and anti-platelets therapy was resumed from POD 3. The patient was discharged from hospital on POD 16. In patients with Leriche syndrome, blood supply to the pelvic organs and lower extremities is maintained by collateral circulation, and organ damages are frequently seen. In addition, perioperative anti-platelets therapy affects surgical outcomes. Therefore, a cautious and well-prepared abdominal surgical plan, including operative procedures and perioperative management, is essential.
