Pregnancy, delivery, and breastfeeding after total gastrectomy for gastric cancer: a case report

Abstract

BackgroundThe reports of pregnancy after total gastrectomy for gastric cancer are rare.Case presentationWe report a case of a 35-year-old woman, gravida 0, para 0, who became pregnant and delivered a baby 2 years and 6 months after laparoscopic-assisted total gastrectomy for early gastric cancer. Postoperatively, she showed a good progress during the follow-up and was continuously taking oral iron supplement and administered with methylcobalamin intramuscular injection. Two years after gastrectomy, she became pregnant. During the pregnancy, she kept taking iron and vitamin B12 supplementation and had a good course of pregnancy and a normal delivery. However, 2 months after the delivery, liver dysfunction was detected via blood examination. The patient switched from exclusive breastfeeding to combined feeding with formula, and her laboratory results returned to normal. During 10 years of follow-up after the delivery, the patient was in good condition without any recurrence and nutritional deficiencies, and her child had thrived.ConclusionsCareful monitoring and management of iron and vitamin deficiencies are essential during pregnancy and the lactation periods for patients who previously underwent total gastrectomy. During the lactation period, a combination of formula and breastfeeding provides maternal and fetal nutritional support.

Updated European guidelines for clinical management of familial adenomatous polyposis (FAP), MUTYH-associated polyposis (MAP), gastric adenocarcinoma, proximal polyposis of the stomach (GAPPS) and other rare adenomatous polyposis syndromes: a joint EHTG-ESCP revision

“…The timing of surgery may be individualized, taking into account patient preferences, while clearly explaining the risks of delay 308 . Women of child-bearing age should be reassured that prophylactic gastrectomy is compatible with successful childbirth and breastfeeding 311 . Both laparoscopic and robotic total gastrectomy may be appropriate 309 , 312 .…”

“…Annual gastroscopic surveillance should be performed in these patients and in patients who are not fully fit for surgery 308 . Women of child-bearing age should be assured of the real chance of uncomplicated pregnancy with successful childbirth and breastfeeding after prophylactic gastrectomy 311 . Both laparoscopic total gastrectomy 309 and robotic total gastrectomy 312 were recently used for GAPPS treatment.…”

Pregnancy and Gastric Cancer: A Narrative Review

“…In pregnancy, the established etiological factors of gastric cancer remain up-to-date, with the mention that the physiological features of pregnancy can participate in neoplastic etiopathogenesis. Isobe et al demonstrated that estrogens, which increase during pregnancy, favor the growth of diffuse-type adenocarcinoma, and the immunosuppressive influence of pregnancy can be an additional factor in the development of the cancer [32,33].…”