Abstract
Purpose: Clinical treatment of gastrointestinal neoplasms in
patients with severe coronary stenosis is difficult, and it remains
controversial to perform staged or simultaneous surgeries. The purpose
of this study was to retrospectively analyze the feasibility and
indications for simultaneous gastrointestinal tumor resection and
off-pump coronary artery bypass (OPCAB) graft surgery.
Methods: Data collected from a total of five patients, including
three patients with gastric cancer and two patients with colorectal
cancer, who underwent simultaneous radical cancer resection and OPCAB
between September 2010 and October 2019, were retrospectively analyzed.
Among these patients, one had an incomplete colonic obstruction. All
patients had severe coronary stenosis, and one experienced acute heart
failure before surgery. OPCAB was performed first, followed by the
radical cancer resection.
Results: All five patients were discharged from hospital without
perioperative death, major cardiovascular events or anastomotic leakage.
The mean postoperative hospital stay was 9.4 days. One patient
experienced slight gastrointestinal bleeding after surgery, which
improved with conservative treatment. After a mean follow-up of 39
months, two patients with gastric cancer died from tumor metastasis at
28 months and 37 months, while the remaining three patients did not have
tumor recurrence or metastasis. None of the patients experienced
myocardial ischemia.
Conclusion: It is safe and feasible to perform simultaneous OPCAB
and gastrointestinal surgeries on the premise of strictly controlling
the indications for patients with gastrointestinal tumors complicated
with severe coronary artery stenosis.
Keywords : digestive tract cancer, coronary heart
stenosis, simultaneous surgery, OPCAB, gastrointestinal surgery.