Results
Following OPCAB, the hemodynamics of all patients were stable, and the gastric or colon tumor resection was successfully performed without perioperative death. The average length of the operation was 7.47 h (6.4-10.0 h), the average number of grafts per patient was 3.2 (2.0-5.0), the average time spent on ventilation was 13.1 h (10.1-16.5 h), and the average postoperative blood transfusion volume was 2.8 U (2.0-4.0 U). The average length of stay in the ICU was 15.8 h (13.0-19.0 h), and the average length of the entire hospital stay was 9.4 d (6.0-13.0 d). None of the patients had major cardiovascular events after the operation, nor did any require an additional operation due to bleeding or gastrointestinal fistulas. Gastrointestinal decompression drainage in case 4 revealed brown fluid on the fourth postoperative day. This was accompanied by melena and decreased hemoglobin, which suggested gastrointestinal bleeding. Antiplatelet drugs were stopped, and conservative treatment was provided. The patient improved after four days. During the discontinuation of antiplatelet drugs, the patient did not experience any cardiovascular symptoms such as chest tightness or shortness of breath. Two patients (case 2 and 3) developed atrial fibrillation after surgery, which improved with medication. Case 5 underwent colostomy surgery two months after the combined operation.
The average follow-up was 39 months (5-115 months). Two patients with gastric cancer died at 28 months and 37 months due to tumor metastasis, and there was no chest tightness or shortness of breath during this period. The remaining patients were alive without cardiovascular events or tumor progression at the end of the follow-up period (Table 5).