P3.04-027 Feasibility of Lung Cancer Surgery for the Patient with Previous History of Coronary Artery Bypass Grafting: Topic: Miscellaneous I

Abstract

Owning to the aging society all over the world, high-risk lung cancer patients with severe cardio-pulmonary complications is more common. Among them, thea likelihood to encounter lung cancer patient with a previous history of coronary artery bypass grafting (CABG) has been increasing in our daily practice. However, pulmonary resections after CABG are technically challenging due to the critical adhesions around the CABG field, which need meticulous surgery. Owning to the aging society all over the world, high-risk lung cancer patients with severe cardio-pulmonary complications is more common. Among them, the likelihood to encounter lung cancer patient with a previous history of coronary artery bypass grafting (CABG) has been increasing in our daily practice. However, pulmonary resections after CABG are technically challenging due to the critical adhesions around the CABG field, which need meticulous surgery. Overall patients with previous CABG were comprised of 35 (88%) male with an average age of 70 years and high-smoking rate (40 pack-year smoking). Location of the lung cancer was 26 (65%) in right side, while 27 (68%) were in upper or middle lobe and 11 (28%) in lower lobe.[a1] [y2] Clinical-stage of lung cancers were 22 (55%) in IA, 6 (15%) in IB and 12 (30%) in II or more. Coronary CT was performed before the operation in 13 (35%). Lobectomy was performed in 27 (68%), segmentectomy in 6 (15%), wedge resection in 7 (18%), and mediastinal node dissection in 12 (30%), respectively. Regarding CABG surgery, harvest of left / right internal thoracic artery was performed in 20 (50%) / 21 (53%). Adhesions around CABG fields were observed in 7 (58%) / 5 (23%), including 9 (75%) upper or middle lobe lung cancer needing perivascular exfoliation without any intraoperative graft damage. Postoperative complications were shown in 13 (33%), but the 30days mortality was 0%. The 3-year survival rate was 71.6%, 3-year lung cancer specific survival rate was 76.1%. Results Owning to the aging society all over the world, high-risk lung cancer patients with severe cardio-pulmonary complications is more common. Among them, the likelihood to encounter lung cancer patient with a previous history of coronary artery bypass grafting (CABG) has been increasing in our daily practice. However, pulmonary resections after CABG are technically challenging due to the critical adhesions around the CABG field, which need meticulous surgery.