# Open Distal Gastrectomy for Gastric Cancer in an Older Patient With Severe Chronic Obstructive Pulmonary Disease Under Combined Spinal–Epidural Anesthesia and Sedation: A Case Report

## TL;DR

This case report describes a successful gastrectomy in an elderly patient with severe lung disease using a special anesthesia method to avoid breathing complications.

## Contribution

The report presents a novel approach using combined spinal–epidural anesthesia and sedation for gastrectomy in patients with severe respiratory dysfunction.

## Key findings

- Combined spinal–epidural anesthesia with dexmedetomidine sedation was successfully used for open distal gastrectomy.
- The approach avoided general anesthesia, potentially reducing postoperative pulmonary complications.
- The patient had severe chronic obstructive pulmonary disease but tolerated the procedure well.

## Abstract

Only a few reports have described gastrectomy performed avoiding general anesthesia to prevent postoperative pulmonary complications in patients with severe respiratory dysfunction. An 80‐year‐old male patient with severe chronic obstructive pulmonary disease was scheduled to undergo surgery for advanced gastric cancer. We successfully managed him using combined spinal–epidural anesthesia with dexmedetomidine sedation during open distal gastrectomy.