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Laparoscopic Total Gastrectomy with Roux-en-Y Esophagojujenostomy in a CDH1 Gene Mutation Patient with Morbid Obesity

Adel Alhaj Saleh, MD, MRCS, Amir H Aryaie, MD, FACS. Texas Tech University Health Sciences Center

  • A 27 year-old female  (BMI of 51 kg/m2 ) came to us for prophylactic total gastrectomy after seeing her genetic counselor as she has CDH1 gene mutation
  • She underwent preoperative evaluation including EGD with random biopsies, no gross or microscopic evidence of cancer was seen.

Medical History

  • Morbid obesity (BMI 51 kg/m2)
  • PCOs
  • HTN
  • Depression
  • Hypothyroidism.
  • Hyperlipidemia

The patient was then planned to

  • Laparoscopic total gastrectomy with Roux-en-Y esophagojejunostomy with D1 lymphadenectomy

Post-operative Course

  • POD #1 UGI showed no leak
  • Discharged after an uneventful postoperative recovery on POD #3 tolerating post-bariatric diet.
  • 2 and 6-week clinic follow up – no nausea/vomiting/food intolerance

In Conclusion

  • Prophylactic laparoscopic total gastrectomy with D1 lymphadenectomy is a safe and feasible option for eliminating the risk of gastric cancer in CDH1 mutation

Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 96045

Program Number: V368

Presentation Session: Video Loop Day 4

Presentation Type: VideoLoop

43

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