Omental transfer for mediastinitis in a patient with early gastric cancer.

We encountered a patient with mediastinitis after coronary artery bypass grafting and early gastric cancer requiring surgical resection. We treated the patient's mediastinitis by omental transfer since complete resection of the malignancy did not require omentectomy. However, in the procedure for harvesting an omental flap, lymph nodes along the gastroepiploic artery (GEA) were left in the stomach for dissection after recovery from mediastinitis; the greater omentum was divided along the outside of the GEA, and was used as a flap based on the left GEA. After mediastinitis was successfully treated, the patient underwent distal gastrectomy and resection of lymph nodes, including those along the GEA. Although indication for omental transfer must be carefully considered when selecting this procedure for mediastinitis patients with malignancies of the abdomen, this technique of harvesting the greater omentum was useful in the present case of a mediastinitis patient with surgical indications of early gastric cancer.