title: Lobectomy for Non-Small Cell Lung Cancer after Coronary Artery Bypass Grafting Surgery.
abstract: BACKGROUND
  The efficacy of video-assisted thoracoscopic surgery lobectomy in patients with previous coronary artery bypass grafting (CABG) surgery is controversial.
  
  
  OBJECTIVE
  To investigate whether skeletonized left internal mammary artery (LIMA) mobilization contributes to the development of severe adhesions, which will affect what type of lung surgery (open or closed procedure) will be required in the future.
  
  
  METHODS
  Eight patients (mean age 73.9 years) with previous CABG surgery using a LIMA to left anterior descending (LAD) graft underwent left-sided lobectomy for operable non-small cell lung carcinoma.
  
  
  RESULTS
  The lobectomy by thoracotomy rate was 62.5% (5 patients), generally in patients with tumors in the left upper lobe or in patients post-neoadjuvant chemotherapy, while the video-assisted thoracic surgery lobectomy rate was 37.5% (3 patients). Mean hospital stay was 8.3 days. There was no mortality or major morbidity, apart from six minor complications in four patients (50%) (air leak, atrial fibrillation, atelectasis, pneumonia).
  
  
  CONCLUSIONS
  Patients with operable non-small cell lung carcinoma following CABG surgery who need left upper lobe resection do not benefit from the video-assisted thoracoscopic surgery technique due to significant adhesions between the LIMA to LAD graft and the lung. The method of preserving a small portion of the lung on the LIMA to LAD graft may help during left upper lobe resections. Adhesions in the left pleural space after LIMA mobilization appear to minimally affect left lower lobe video-assisted thoracoscopic surgery.
authors.forename: Michael
authors.initials: M
authors.lastname: Papiashvili
authors.forename: Ehud
authors.initials: E
authors.lastname: Deviri
authors.forename: Ilan
authors.initials: I
authors.lastname: Bar
authors.forename: Lior
authors.initials: L
authors.lastname: Sasson
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D001026:Coronary Artery Bypass; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008323:Mammary Arteries / Q000601:surgery; D011013:Pneumonectomy / Q000379:methods; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D000267:Tissue Adhesions / Q000473:pathology*