Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients

Abstract

ObjectiveThe co-incidence of esophageal cancer and coronary heart disease (CHD) is increasing in elderly patients. This study was carried out to analyze the efficiency and safety of simultaneous esophagectomy and cardiac surgery in a selected group of elderly patients.MethodsProspective database for coexistency of severe CHD and esophageal or esophageal-gastric junction cancer was firstly reviewed. Twenty-two patients undergoing combined surgical interventions, including first beating-heart coronary artery bypass grafting (off-pump CABG) and then esophagectomy, were involved as group A. Then, 44 patients undergoing isolated esophagectomy were selected as group B using the propensity score matching method. Data including clinic pathological characteristics and postoperative outcomes were investigated. Kaplan–Meier analysis was used.ResultsThe surgical procedure was performed through left lateral thoracotomy in all patients, except one patient in group A who received median sternotomy and left lateral thoracotomy. The operation time and blood loss were both more in group A, as a result of two operations performed at one session. Patients in both groups were followed up from 1.3 to 78.3 months. No significant between-group was found in overall survival or relapse-free survival.ConclusionThe risk of simultaneous esophagectomy and cardiac surgery is not high. Despite certain differences in clinical indicators between groups, the safety of simultaneous procedures in group A is evident.Trial registrationChiCTR 1800014498. Registered 17 January 2018Electronic supplementary materialThe online version of this article (10.1186/s12957-018-1512-5) contains supplementary material, which is available to authorized users.

Feasibility of radical gastrointestinal tumor resection with simultaneous off‐pump coronary artery bypass surgery for patients with severe heart problems: A retrospective cohort study from a single institutional database

“…We found that the concurrent radical resection of the gastrointestinal tumor was performed under stable hemodynamics, and the radical resection of the operation was not affected 28 . The follow-up data also suggest that the overall survival and relapse-free survival after the concurrent surgeries are equivalent to those of radical gastrointestinal surgery alone 29 . A study of concurrent surgery for gastric cancer and CABG suggested that the long-term prognosis depends on the staging status of the gastric cancer at the time of diagnosis 10 .…”

“…Shapira et al reported that CABG in patients with left ventricular ejection fraction (LVEF) < 30% can be performed with low mortality, but with higher morbidity and longer length of hospital stay compared with patients with LVEF > 30% 16 . Zhang and colleagues proposed that concurrent surgery is not recommended for patients with LVEF < 45%, 17 and Davydov and colleagues have stated that LVEF < 20% is a contraindication for concurrent surgery 15 . However, Takahashi et al 13 reported that concurrent CABG and radical gastrointestinal tumor resections were safe and feasible in patients with low LVEF.…”

“…30 The follow-up data also suggest that the overall survival and relapse-free survival after the concurrent surgeries are equivalent to those of radical gastrointestinal surgery alone. 17 A study of concurrent surgery for gastric cancer and CABG suggested that the long-term prognosis depends on the staging status of the gastric cancer at the time of diagnosis. 9 Anastomotic leakage is a common and serious complication.…”

Feasibility of Radical Gastrointestinal Tumor Resection with Simultaneous off-Pump Coronary Artery bypass Surgery for Patients with Severe Heart Problems: A Retrospective Cohort Study from A Single Institutional Database

“…We found that the concurrent radical resection of the gastrointestinal tumor was performed under stable hemodynamics, and the radical resection of the operation was not affected 28 . The follow-up data also suggest that the overall survival and relapse-free survival after the concurrent surgeries are equivalent to those of radical gastrointestinal surgery alone 29 . A study of concurrent surgery for gastric cancer and CABG suggested that the long-term prognosis depends on the staging status of the gastric cancer at the time of…”

Simultaneous surgical resection of cardiac myxoma and atypical thymic carcinoid: a case report

“…A two-stage surgery may have offered the advantage of a lower risk of scattering tumor cells, but would also have disadvantages such as a longer total duration of therapy and potential difficulties in the second stage due to adhesions. Several groups have reported surgical approaches for combined heart diseases and other malignancies, and concluded that simultaneous surgery was not associated with any adverse impacts on morbidity, mortality, or recurrence-free survival [ 5 , 8 ]. On the other hand, Hasegawa et al.…”