title: Simultaneous esophagectomy and off-pump coronary artery bypass grafting: a practicable approach with good survival.
abstract: Surgery continues to be the mainstay of esophageal cancer treatment. However, it is a big challenge for the surgical treatment of patients with both esophageal cancer and coronary artery disease (CAD). We reported, here, the first case series of esophageal cancer patients treated with simultaneous esophagectomy and off-pump coronary artery bypass grafting (CABG). From August 2010 to August 2012, 2154 esophageal or esophageal gastric junction (EGJ) cancer patients underwent surgical treatment in Tangdu Hospital, Xi'an, China. Among them, six patients with esophageal or EGJ esophageal gastric junction cancer complicated with CAD were given simultaneous esophagectomy and off-pump CABG, and were followed up until August 2014. Four patients were operated through left lateral thoracotomy and two patients were operated through median sternotomy plus upper midline laparotomy. All the patients survived the operation well and the postoperative morbidity rate was 67% (one anastomosis leakage, three cardiac arrhythmias). There was no postoperative mortality. The mean follow-up time was 34.5 ± 7.8 months (range, 24-46 months). One patient died 36 months later due to tumor recurrence and all the other patients survived until the time to follow up. Simultaneous esophagectomy and off-pump CABG approach might be a safe and effective procedure with good survival in selected patients with both esophageal cancer and CAD.
authors.affiliation: Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China.
authors.forename: J
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China.
authors.forename: J
authors.initials: J
authors.lastname: Lei
authors.affiliation: Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Lu
authors.affiliation: Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China.
authors.forename: F
authors.initials: F
authors.lastname: Tian
authors.affiliation: Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China.
authors.forename: E
authors.initials: E
authors.lastname: Yang
authors.affiliation: Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China.
authors.forename: X
authors.initials: X
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002681:China; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004943:Esophagogastric Junction / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D056346:Sternotomy; D013908:Thoracotomy
keywords: coronary artery disease; esophageal cancer; esophagectomy; long-term survival; off-pump coronary artery bypass grafting