Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients.
BACKGROUND
To analyze the outcomes of off-pump coronary artery bypass grafting (OPCABG) and esophagectomy simultaneously for patients with coronary artery disease (CAD) and coexisting esophageal cancer.


METHODS
Twenty-two patients with CAD and coexisting esophageal cancer underwent combined surgical interventions were subjected to the study. OPCABG was performed first, followed by esophagectomy. All the corresponding data including clinicopathological characteristics and postoperative outcomes were all investigated.


RESULTS
All the combined procedures were performed successfully. The average number of grafts was 2.36. Tumors were located at the middle third of the esophagus in 5 patients, at the lower third of the esophagus in 8 patients, at the esophageal gastric junction (EGJ) in 9 patients, respectively. The operations were carried out through a left lateral thoracotomy approach in 21 patients while a median sternotomy and left lateral thoracotomy approach was used in 1 patient for his condition rapidly worsened. Postoperatively, pneumonia occurred in 4 patients (18.2%). During the follow-up, three patients died of cancer metastasis /recurrence (6, 18, 37 months) and one died of pneumonia (1 month). The cumulative 5 years survival rate is 52.9%.


CONCLUSIONS
The combined procedure of OPCABG and esophagectomy is a safe and effective treatment option for patients with severe CAD and esophageal cancer.
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Ban
B
Liu
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Chang
C
Gu
School of Public Health, Nanjing Medical University, Nanjing, China.
Yuliang
Y
Wang
Department of Cardiovascular Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing Medical University, Nanjing, China.
Xiaowei
X
Wang
Department of Cardiovascular Surgery,Shuguang Hospital, Affiliated to Shanghai University of TCM, Shanghai, China.
Wen
W
Ge
The First Clinical Medical College of Nanjing Medical University, Nanjing, China.
Lingtong
L
Shan
The First Clinical Medical College of Nanjing Medical University, Nanjing, China.
Yujian
Y
Wei
Department of Cardiovascular Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing Medical University, Nanjing, China.
Xiaohan
X
Xu
Department of Cardiovascular Surgery, East Hospital, Tongji University School of Medicine, Shanghai, China.|Key Laboratory of Arrhythmias of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China.
Yangyang
Y
Zhang
D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011183:Postoperative Complications; D016896:Treatment Outcome
coronary artery disease; esophagectomy; off-pump coronary artery bypass grafting; outcome; simultaneous