Synchroneously occurring lung cancer (stages I–II) and coronary artery disease: concomitant versus staged surgical approach

Abstract

No difference in survival between the two groups, one operated upon in a staged procedure, the other concomitantly, could be demonstrated. However, the greater perioperative risk makes the concomitant procedure less attractive, and the staged approach the preferred one. Interval between operations can be individualized according to the clinical status of the particular patient to a period as short as 2 weeks.

Cardiac surgery Long-term results after concomitant cardiac surgery and pulmonary resection

“…Perioperative mortality and oncologic 5-year survival practically did not change, remaining at the level 0-6% and 9-86% respectively. As in our study, most operations [3,[10][11][12][13][14][15][16] were performed in one stage with the cardiac procedure followed by lung resection. Voets et al [3] compared one-stage versus two-stage procedures and concluded that there was no difference between the two groups regarding mortality; however, greater perioperative risk makes concomitant procedures less attractive.…”

“…Voets et al [3] and Hosoba et al [16] reported that a number of patients underwent a lung resection through a separate thoracotomy after the sternum was closed. Dyszkiewicz et al [10,14] and Saxena et al [11] advocate concomitant one-stage off-pump coronary revascularization and lung resection.…”

“…In 1978 Dalton [2] reported the first experience with a one-stage cardiac operation and lung resection. Several studies have found that either a combined or staged procedure is effective [3]. Regarding safety, cost, hospital stay, and delay in tumor management, each technique has its own benefits and drawbacks in treating these high-risk patients.…”

Surgical organ-sparing treatment in a patient with central cancer in the right lung concurrent with cardiovascular disease complicated by pulmonary hemorrhage

“…Пре-имуществом данного подхода является меньшая частота осложнений и летальность. Так, после последователь-ных операций послеоперационная летальность достига-ет 10,0%, а при одномоментных -20,8% [2,6]. В то же время, по данным В.А.…”

“…Лечебная тактика у этого контин-гента больных зависит от конкретной клинической ситу-ации. Большинство авторов, при наличии в клинике кар-диохирургии, предпочитают одномоментные вмешатель-ства, другие -на первом этапе выполняют коррекцию сердечно-сосудистой патологии, на втором -операцию на легком [3][4][5][6][7]. Наиболее сложной является ситуация, когда у соматически отягощенного больного течение рака легкого осложняется абсцедированием, кровотечением и т.д.…”