Use of Off-pump Coronary Artery Bypass Surgery Among Patients with Malignant Disease

Darwazah, F.R.C.S. Ahmad K.; Osman, Mohamed; Sharabati, Barakat

doi:10.1111/j.1540-8191.2008.00778.x

Cited by 23 publications

(22 citation statements)

References 16 publications

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“…Optimal treatment strategies for simultaneously diagnosed esophageal cancer and CAD remain debatable. The two associated procedures are performed simultaneously by a one-staged operation [19,20] or separately by two-staged operations [21, 22]. CAD leads to surgical morbidity of patients with malignant disease, and cardiac revascularization should be carried out first to avoid perioperative risk of myocardial ischemia or infarction and cardiac dysfunction [23].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients

Liu

Wang

et al. 2017

Oncotarget

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IntroductionTo analyze the outcomes of off-pump coronary artery bypass grafting (OPCABG) and esophagectomy simultaneously for patients with coronary artery disease (CAD) and coexisting esophageal cancer.MethodsTwenty-two patients with CAD and coexisting esophageal cancer underwent combined surgical interventions were subjected to the study. OPCABG was performed first, followed by esophagectomy. All the corresponding data including clinicopathological characteristics and postoperative outcomes were all investigated.ResultsAll the combined procedures were performed successfully. The average number of grafts was 2.36. Tumors were located at the middle third of the esophagus in 5 patients, at the lower third of the esophagus in 8 patients, at the esophageal gastric junction (EGJ) in 9 patients, respectively. The operations were carried out through a left lateral thoracotomy approach in 21 patients while a median sternotomy and left lateral thoracotomy approach was used in 1 patient for his condition rapidly worsened. Postoperatively, pneumonia occurred in 4 patients (18.2%). During the follow-up, three patients died of cancer metastasis /recurrence (6, 18, 37 months) and one died of pneumonia (1 month). The cumulative 5 years survival rate is 52.9%.ConclusionsThe combined procedure of OPCABG and esophagectomy is a safe and effective treatment option for patients with severe CAD and esophageal cancer.

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Section: Discussionmentioning

confidence: 99%

Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients

Liu

Wang

et al. 2017

Oncotarget

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“…A recent trend has been the use of off-pump CABG to avoid the effect of cardiopulmonary bypass and decrease the use of heparin (10,14,15). The off-pump technique could markedly lower the risk of the disadvantages related to use of cardiopulmonary bypass, although other studies found no advantage of using an off-pump technique compared with cardiac surgery using cardiopulmonary bypass (3,(13)(14)(15). The present study demonstrated that concomitant OPCAB and non-cardiovascular surgery compared with those of isolated OPCAB did not increase operative mortality and perioperative morbidities, although the majority of patients had concomitant malignant disease and underwent laparotomy (63 patients had combined malignant diseases; 62 patients underwent general surgeries opening the abdominal cavity).…”

Section: Discussionmentioning

confidence: 98%

“…Surgical treatment can be performed separately by 2-stage operations or simultaneously by a concomitant operation. The 2-stage procedure, prior successful CABG followed by non-cardiovascular surgery, has been demonstrated to reduce mortality and morbidities; however, this technique was associated with higher cost, delay in surgery for malignant disease, and longer hospital stay (2,3,8). An unpredictable delay between the two procedures could be detrimental in cases of malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…However, the exact timing of CABG and composition of an appropriate patient population remained undefined. In addition, the staged procedures were associated with higher cost, delay in surgery for non-cardiovascular malignant disease, and longer hospital stays (3). Although concomitant operations avoid the need for a second operation and reduce the overall hospital stay and cost, surgeons are reluctant to perform concomitant cardiac and non-cardiovascular operations because of concerns about systemic heparin administration and exposure of two different operative fields (4).…”

Section: Original Articlementioning

confidence: 99%

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Concomitant off-pump coronary artery bypass and non-cardiovascular surgery

Han

Choi

et al. 2016

J. Thorac. Dis.

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Background: Reports on concomitant cardiac and non-cardiovascular surgeries have noted disadvantages in the use of extracorporeal circulation. We assessed the results of concomitant off-pump coronary artery bypass (OPCAB) and non-cardiovascular surgery, and compared them with isolated OPCAB results.Methods: Of 2,439 patients who underwent OPCAB between 1999 and 2014, 115 patients underwent concomitant OPCAB and non-cardiovascular surgery. Combined non-cardiovascular diseases included 63 malignant and 52 benign diseases. Concomitant non-cardiovascular surgeries performed were general (n=62), thoracic (n=47), orthopedic (n=3), urologic (n=2) and otolaryngologic surgeries (n=1). Operative results were compared between the OPCAB patients who underwent concomitant non-cardiovascular surgeries (group 1, n=115) and isolated OPCAB patients (group 2, n=2,251). Because preoperative characteristics of the two groups were different, a 1:2 propensity score-matched analysis was performed and operative results of the two matched groups were compared.Results: Operative mortality rates were 0.9% (1/115) in group 1 and 1.0% (22/2,251) in group 2 (P=0.909).Although there were differences in preoperative patient characteristics, postoperative complications, including atrial fibrillation (36.5% vs. 28.8%), perioperative myocardial infarction (MI) (4.3% vs. 5.2%), acute renal failure (1.7% vs. 4.9%), mediastinitis (0.9% vs. 0.8%), bleeding reoperation (0.9% vs. 2.9%), and respiratory complications (2.6% vs. 2.1%), did not show significant differences between the two groups.After a 1:2 propensity score-matched analysis, there were no statistical differences in operative complications between the two groups.Conclusions: Concomitant OPCAB and non-cardiovascular surgeries were not associated with increased mortality and postoperative morbidities when compared with isolated OPCAB.

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“…(Resim 1-3) Nadiren de olsa sol anterolateral veya posterolateral torakotomiyle yapılan olgular da mevcuttur (Resim 4-7). Bu ameliyatları pompa kullanmaksızın (Off-pump) yapmayı tercih eden cerrahlar da mevcuttur (20,21,22). Her iki tür operasyonun da avantaj ve dezavantajlarını ifade eden çok sayıda yayın vardır.…”

Section: İskemi̇k Kalp Hastaliklari Ve Akci̇ğer Hastaliklariunclassified

Sımultaneous Lung Cancer And Heart Dısease

Okay¹

2016

Toraks Cer Bult

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Worldwide, especially in developed countries, prolonged life expectancy results in increasing number of age-related / associated diseases like diabetes mellitus, cardiovascular diseases, malignancies, neurological diseases, organ failures etc. in the community. Beside the numbers, planning and applying the treatment of pulmonary and cardiovascular diseases simultaneously in such patients is stil a major challenge. The knowledge and experience gained from the increasing number of patients all over the world led to the conclusion that it could be possible to treat some patient groups who would be considered as difficult or impossible to cure in the past. In this paper we evaluated the treatment process in lung diseases (especially malignancies) and cardiovascular disease seen simultaneously.Keywords: Lung cancer, heart disease, coronary artery disease, pulmonary surgery, concurrent heart lung disease, concurrent heart lung surgery ÖzetÖzellikle batıda olmak üzere tüm dünyada uzayan ortalama ömür süresi, yaşa bağlı/ilintili hastalıkların da toplumda daha sık görülmesi sonucunu doğurmaktadır. Bunlar diyabet, kalp damar hastalıkları, maligniteler, nörolojik hastalıklar, organ yetmezlikleri gibi hastalıklardır. Bu durumun yarattığı sorunlardan biri de eş zamanlı olarak görülen akciğer ve kalp damar hastalıklarının tedavisinin planlanması ve uygulanmasıdır. Tüm dünyada giderek artan sayıdaki hastalardan elde edilen bilgi ve deneyimler eskiden çok zor hatta imkansız olarak kabul edilen hasta gruplarında bile tedavi seçenekleri olabileceğini ve başarıyla uygulanabileceğini göstermektedir. Bu yazıda eş zamanlı görülen kalp-damar hastalıkları ve özel-likle maligniteler olmak üzere akciğer hastalıklarındaki tedavi süreçlerini değerlendirdik.Anahtar kelimeler: Akciğer kanseri, kalp hastalığı, koroner arter hastalığı, akciğer cerrahisi, eş zamanlı kalp akciğer hastalığı, eş zamanlı kalp akciğer cerrahisi

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Use of Off-pump Coronary Artery Bypass Surgery Among Patients with Malignant Disease

Abstract: We believe that staged operation to treat coronary artery disease and malignancy can be performed safely. The use of off-pump technique to revascularize the myocardium can be performed without any complications.

Cited by 23 publications

References 16 publications

Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients

Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients

Concomitant off-pump coronary artery bypass and non-cardiovascular surgery

Sımultaneous Lung Cancer And Heart Dısease

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