Simultaneously performed off-pump coronary artery bypass grafting and colectomy: a case report

Panagiotis Dedeilias,Serafim Klimopoulos,Ioannis Nenekidis,Panagiotis Hountis,Nikolaos G Baikoussis,Dimitrios Exarhos,Efstratios Koletsis

doi:10.1186/1477-7819-8-50

Abstract

This is written so as to report the case of a 71-year-old male with a diagnosis of sigmoid adenocarcinoma accompanied by severe coronary artery disease and unstable angina, which was subject to simultaneous surgical treatment. The patient initially underwent an off-pump coronary artery revascularization in order to avoid the complications of cardiopulmonary bypass, providing the opportunity of a colectomy at the same time with the use of safe surgical means. Our case suggests that performing an off-pump bypass procedure prior to cancer surgery can be an appropriate course of action in carefully selected cases.

Highlights

Up to now, patients being surgically treated at the same time for two non related reasons was not a common practice in medicine
We are describing the simultaneous surgical procedure of a patient with hemorrhagic left colon cancer combined with severe coronary artery disease
It is of great importance to mention that late complications of extracorporeal circulation contribute indirectly to the expansion of the existing malignancy according to the international bibliography [1,2,3]

Summary

Introduction

Patients being surgically treated at the same time for two non related reasons was not a common practice in medicine. There is some skepticism regarding the effect of the extracorporeal circulation (ECC) on the expansion of the coexisting malignancy When both pathologies are acute, sometimes there is not adequate time to spend on deciding which disease calls for more immediate action. We are describing the simultaneous surgical procedure of a patient with hemorrhagic left colon cancer combined with severe coronary artery disease. Case Report A 71-year-old man was admitted to the intensive care unit of our hospital with chest pain, progressive dyspnoea and bleeding from the left colon. His medical history pointed out that a month ago he suffered from an acute myocardial infarction treated conservatively without any intervention. Histopathological findings were indicative of a well-differentiated intramucosal intestinal adenocarcinoma with multiple non infiltrated lymph nodes (Classification according to WHO: T1N0M0, Stage A according to Duke)

Discussion

Findings

Conclusion