Simultaneous Minimally Invasive Coronary Artery Bypass Grafting and Lung Resection.

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Thoracic and Cardiovascular Surgeon Pub Date : 2024-09-01 Epub Date: 2023-09-29 DOI:10.1055/a-2184-6624
Jiang Lianyong, Gao Pengkai, Zhang Xuefeng, Ding Fangbao, Liu Hao
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引用次数: 0

Abstract

Background:  The best surgical treatment strategy for coexisting coronary artery disease (CAD) and lung cancer (LC) remains controversial. This study analyzed the safety and efficacy of a simultaneous minimally invasive procedure for patients with CAD and LC.

Methods:  Patients who underwent simultaneous minimally invasive off-pump coronary artery bypass grafting and lung resection from January 2016 to December 2021 were retrospectively analyzed. The procedure was performed in the fourth intercostal space through a small left anterolateral minithoracotomy. Harvesting of the left internal mammary artery (LIMA) and sewing of the anastomoses were performed under direct vision. Lung resections were performed with or without the assistance of a thoracoscope.

Results:  Sixteen patients were included with a mean age of 67.13 ± 10.61 years. Procedural success occurred in all patients with a mean operative time of 366.88 ± 94.48 minutes. All patients received at least one coronary artery bypass LIMA graft. Pneumonectomy, lobectomy, segment resection, and wedge resection were performed in one (6.25%), eight (50%), two (12.5%), and five (31.25%) patients, respectively. There were no perioperative deaths or new myocardial infarctions. Complications included one case of postoperative bleeding, two lung infections, two cases of atelectasis, one case of pleural effusion, and one case of cardiac arrhythmia. All the patients were followed up for 1 to 57 months, cancer recurrence occurred in two patients, and one patient died. The remaining patients showed no evidence of tumor recurrence or myocardial infarction.

Conclusion:  This simultaneous minimally invasive procedure is safe and effective for selected patients with CAD and LC.

同时进行微创冠状动脉搭桥术和肺切除术。
背景:癌症与冠状动脉疾病并存的最佳手术治疗策略仍然存在争议。本研究分析了同时微创手术治疗冠心病和肺癌癌症患者的安全性和有效性。方法:对2016年1月至2021年12月同时接受微创非体外循环冠状动脉搭桥术和肺切除术的患者进行回顾性分析。手术在第四肋间通过小的左前外侧小切口进行。左胸内动脉(LIMA)的采集和吻合口的缝合在直视下进行。肺切除术是在有或没有胸腔镜辅助下进行的。结果:纳入16例患者,平均年龄67.13±10.61岁。所有患者的手术均取得成功,平均手术时间为366.88±94.48分钟。所有患者均接受了至少一次冠状动脉搭桥LIMA移植物。分别对1例(6.25%)、8例(50%)、2例(12.5%)和5例(31.25%)患者进行了肺切除、肺叶切除、节段切除和楔形切除。无围手术期死亡或新发心肌梗死。并发症包括术后出血1例,肺部感染2例,肺不张2例,胸腔积液1例,心律失常1例。术后随访1~57个月,癌症复发2例,死亡1例。其余患者没有肿瘤复发或心肌梗死的迹象。结论:同时微创手术对选择冠心病和肺癌癌症患者是安全有效的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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