Abstract

IntroductionOptimal surgical approach for the treatment of resectable lung cancer accompanied by coronary artery disease (CAD) remains a contentious issue. In this study, we present our cases that were operated simultaneously for concurrent lung cancer and CAD.MethodsSimultaneous off-pump coronary artery bypass surgery (OPCABG) and lung resection were performed on 10 patients in our clinic due to lung cancer accompanied by CAD. Demographic features of patients, operation data and postoperative results were evaluated retrospectively.ResultsMean patient age was 63.3 years (range 55-74). All patients were male. Six cases of squamous cell carcinoma, three of adenocarcinoma and one case of large cell carcinoma were diagnosed. Six patients had single-vessel CAD and 4 had two-vessel CAD. Three patients underwent OPCABG at first and then lung resection. The types of resections were one right pneumonectomy, three right upper lobectomies, one right lower lobectomy, three left upper lobectomies, and two left lower lobectomies. Reoperation was performed in one patient due to hemorrhage. One patient developed intraoperative contralateral tension pneumothorax. One patient died due to acute respiratory distress syndrome at the early postoperative period.ConclusionSimultaneous surgery is a safe and reliable option in the treatment of selected patients with concurrent CAD and operable lung cancer.

Highlights

  • Optimal surgical approach for the treatment of resectable lung cancer accompanied by coronary artery disease (CAD) remains a contentious issue

  • As the elderly population increases, there are an increasing number of patients who are diagnosed with lung cancer (LC) and have concurrent heart disease requiring surgical intervention

  • We retrospectively analyzed patients submitted to simultaneous off-pump coronary artery bypass surgery (OPCABG) and lung resection from 2014 to 2018

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Summary

Introduction

Optimal surgical approach for the treatment of resectable lung cancer accompanied by coronary artery disease (CAD) remains a contentious issue. We present our cases that were operated simultaneously for concurrent lung cancer and CAD. As the elderly population increases, there are an increasing number of patients who are diagnosed with lung cancer (LC) and have concurrent heart disease requiring surgical intervention. According to The Society of Thoracic Surgeons database, 20.9% of the patients undergoing pulmonary resection for LC have coronary artery disease (CAD); only 0.4-0.5% of these patients required coronary artery bypass grafting (CABG)[1,2,3]. The cardiac procedure was performed first and after a recovery period of 2 to 8 weeks, pulmonary resection was performed[3]. Simultaneous procedures have a longer operation time and lead to increased risks of operative bleeding, tissue edema and immunosuppression due to cardiopulmonary bypass (CPB)[3,4,5,6]

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