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Lianyong J, Pengkai G, Xuefeng Z, Fangbao D, Hao L. Simultaneous Minimally Invasive Coronary Artery Bypass Grafting and Lung Resection. Thorac Cardiovasc Surg 2024; 72:435-440. [PMID: 37774755 DOI: 10.1055/a-2184-6624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
BACKGROUND The best surgical treatment strategy for coexisting coronary artery disease (CAD) and lung cancer (LC) remains controversial. This study analyzed the safety and efficacy of a simultaneous minimally invasive procedure for patients with CAD and LC. METHODS Patients who underwent simultaneous minimally invasive off-pump coronary artery bypass grafting and lung resection from January 2016 to December 2021 were retrospectively analyzed. The procedure was performed in the fourth intercostal space through a small left anterolateral minithoracotomy. Harvesting of the left internal mammary artery (LIMA) and sewing of the anastomoses were performed under direct vision. Lung resections were performed with or without the assistance of a thoracoscope. RESULTS Sixteen patients were included with a mean age of 67.13 ± 10.61 years. Procedural success occurred in all patients with a mean operative time of 366.88 ± 94.48 minutes. All patients received at least one coronary artery bypass LIMA graft. Pneumonectomy, lobectomy, segment resection, and wedge resection were performed in one (6.25%), eight (50%), two (12.5%), and five (31.25%) patients, respectively. There were no perioperative deaths or new myocardial infarctions. Complications included one case of postoperative bleeding, two lung infections, two cases of atelectasis, one case of pleural effusion, and one case of cardiac arrhythmia. All the patients were followed up for 1 to 57 months, cancer recurrence occurred in two patients, and one patient died. The remaining patients showed no evidence of tumor recurrence or myocardial infarction. CONCLUSION This simultaneous minimally invasive procedure is safe and effective for selected patients with CAD and LC.
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Affiliation(s)
- Jiang Lianyong
- Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Gao Pengkai
- Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Zhang Xuefeng
- Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
- Department of Radiology, The First Affiliated Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Ding Fangbao
- Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Liu Hao
- Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
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Porkhanov VA, Belash SA, Polyakov IS, Barbukhatti KO, Kononenko VB, Kovalenko AL, Sitnik SD. [Simultaneous surgery for concomitant lung cancer and diffuse coronary atherosclerosis]. Khirurgiia (Mosk) 2021:42-49. [PMID: 33710825 DOI: 10.17116/hirurgia202103142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the early outcomes of simultaneous surgeries in patients with concomitant lung cancer and coronary artery disease. MATERIAL AND METHODS We retrospectively reviewed 37 consecutive patients who underwent CABG with adjunct endarterectomy (n=21) or long segmental coronary artery reconstruction (n=25) and lung resection between 2003 and 2019. Mean age was 61.4±6.7 (range 58-71) years. Males prevailed (n=32, 86.4%). Median sternotomy was used in all patients. Myocardial revascularization was followed by on-pump lung resection. The most common procedure was lobectomy (94.6%) of the right upper lobe (83.7%). Lymph node dissection was performed in all patients. RESULTS CPB time was 162±19.3 min, aortic cross-clamping time 71±14.2 min. There was no in-hospital mortality. Incidence of perioperative myocardial infarction was 5.4%. Postoperative complications were atrial fibrillation (n=6, 16.6%), re-exploration for bleeding (n=1, 2.7%), pneumonia (n=2, 5.4%). Mean hospital-stay was 14.4 days (range 11-21). CONCLUSION Simultaneous lung resections and coronary artery reconstruction is a safe and reliable surgical method in patients with diffuse coronary atherosclerosis and lung cancer. The developed system of choice, evaluation and surgical treatment of patients with concomitant cardiopulmonary pathology is fundamental for successful treatment of these difficult patients. We need larger randomized studies for certainty.
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Affiliation(s)
- V A Porkhanov
- Research Institute - Ochapovskiy Regional Clinical Hospital No.1, Krasnodar, Russia.,Kuban State Medical University, Krasnodar, Russia
| | - S A Belash
- Research Institute - Ochapovskiy Regional Clinical Hospital No.1, Krasnodar, Russia.,Kuban State Medical University, Krasnodar, Russia
| | - I S Polyakov
- Research Institute - Ochapovskiy Regional Clinical Hospital No.1, Krasnodar, Russia
| | - K O Barbukhatti
- Research Institute - Ochapovskiy Regional Clinical Hospital No.1, Krasnodar, Russia.,Kuban State Medical University, Krasnodar, Russia
| | - V B Kononenko
- Research Institute - Ochapovskiy Regional Clinical Hospital No.1, Krasnodar, Russia
| | - A L Kovalenko
- Research Institute - Ochapovskiy Regional Clinical Hospital No.1, Krasnodar, Russia
| | - S D Sitnik
- Research Institute - Ochapovskiy Regional Clinical Hospital No.1, Krasnodar, Russia
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Tricard J, Milad D, Chermat A, Simard S, Lacasse Y, Dagenais F, Conti M. Staged management of cardiac disease and concomitant early lung cancer: a 20-year single-center experience. Eur J Cardiothorac Surg 2021; 59:610-616. [PMID: 33210113 DOI: 10.1093/ejcts/ezaa360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/21/2020] [Accepted: 08/29/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The association of unstable heart disease and resectable lung cancer is rare. The impacts of staged management, cardiac surgery with cardiopulmonary bypass (CPB) versus angioplasty, on long-term survival and cancer recurrence remain debated. We report our experience using staged management. METHODS From 1997 to 2016, 107 patients were treated at the Quebec Heart and Lung Institute: 72 underwent cardiac surgery with CPB (group 1), 35 were treated with angioplasty (group 2), followed by oncological pulmonary resection. RESULTS Two postoperative deaths (3%) and 1 ischaemic heart complication (1%) were reported in group 1. One death (3%) was reported in group 2. Two-year overall survival was 82% (59/72) in group 1 and 80% (28/35) in group 2; 5-year overall survival was 62% (33/53) in group 1 and 63% (19/30) in group 2. Two-year disease-free survival in group 1 was 79% (57/72) and 77% (27/35) in group 2; 5-year disease-free survival was 58% (31/53) in group 1 and 60% (18/30) in group 2. The independent risk factors for death after thoracic surgery were transfusions (P = 0.004) and grade ≥3 complications (P = 0.034). Independent risk factors for recurrence included the cancer stage (P < 0.001) and, paradoxically, a shorter delay between cardiac and lung procedures (P = 0.031). CONCLUSIONS When a staged management remains feasible after cardiac procedure, oncological outcomes of patients with cardiopathy and lung cancer are satisfactory. CPB does not seem to be deleterious. The delay between procedures should intuitively be as small as possible but not at the expense of good recovery after the cardiac procedure.
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Affiliation(s)
- Jérémy Tricard
- Division of Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada.,Cardiac Surgery Department, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada.,Thoracic and Cardiovascular Surgery Department, Limoges University Hospital Center, Limoges, France
| | - Daniel Milad
- Division of Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada
| | - Anaëlle Chermat
- Thoracic and Cardiovascular Surgery Department, Limoges University Hospital Center, Limoges, France
| | - Serge Simard
- Division of Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada.,Cardiac Surgery Department, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada
| | - Yves Lacasse
- Division of Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada
| | - François Dagenais
- Cardiac Surgery Department, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada
| | - Massimo Conti
- Division of Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada
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Yoon DW, Shin DW, Cho JH, Lee JH, Yang JH, Han K, Park SH. Impact of previous percutaneous coronary intervention on cardiovascular outcomes and mortality after lung cancer surgery: A nationwide study in Korea. Thorac Cancer 2020; 11:2517-2528. [PMID: 32657054 PMCID: PMC7471042 DOI: 10.1111/1759-7714.13563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 06/12/2020] [Accepted: 06/17/2020] [Indexed: 11/25/2022] Open
Abstract
Background The number of patients with operable lung cancer with a history of percutaneous coronary intervention (PCI) has increased. However, cardiovascular outcomes and mortality, according to the time from PCI to surgery, and the follow‐up time after surgery are largely unknown. Here, we aimed to compare the cardiovascular outcomes and mortality of these patients with a history of PCI to those of patients without a history of PCI. Methods Using the Korean National Health Insurance Service Database, we selected 30 750 patients who underwent surgery for lung cancer between 2006 and 2014. Study outcome variables were all‐cause mortality, revascularization, intensive care unit (ICU) readmission, and stroke incidence. Patients were followed‐up until 2016. Results Of the 30 750 patients, 513 (1.7%) underwent PCI before surgery. The PCI group did not show an increased risk of death, ICU readmission, or stroke within one year of surgery, despite an increased risk of revascularization. However, one year after surgery, they showed a higher risk of death and revascularization than the non‐PCI group. The risk of revascularization was highest when the interval between PCI and surgery was <1 year and remained high when the interval was >3 years. Conclusions Patients who underwent PCI before surgery for lung cancer were at a higher risk of death than those in the non‐PCI group at one year after surgery. In addition, they showed higher short‐ and long‐term risks of revascularization than patients in the non‐PCI group. Careful long‐term management of cardiovascular risk is necessary for this population.
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Affiliation(s)
- Dong Woog Yoon
- Department of Thoracic and Cardiovascular Surgery, Armed Forces Capital Hospital, Seongnam, South Korea
| | - Dong Wook Shin
- Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Jong Ho Cho
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong-Hwan Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jeong Hoon Yang
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyungdo Han
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Medical Statistics, The Catholic University of Korea, Seoul, South Korea
| | - Sang Hyun Park
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Medical Statistics, The Catholic University of Korea, Seoul, South Korea
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Huang W, Qi K, Chen Z, Li J. [Perioperative Outcomes of Patients Undergoing Pulmonary Resection for Lung Cancer after Coronary Stenting]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2020; 23:36-40. [PMID: 31948536 PMCID: PMC7007396 DOI: 10.3779/j.issn.1009-3419.2020.01.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
背景与目的 肺癌患者合并有冠心病是很常见的一种情况,部分患者既往植入冠脉支架并接受抗血小板治疗。对于带有冠脉支架需要行肺切除手术的肺癌患者,围手术期是否停用抗血小板药物仍然存在争议。本研究通过回顾我院的数据来明确这部分特殊人群的围手术期结局。 方法 回顾性分析了2013年1月-2019年9月冠脉支架术后在北京大学第一医院胸外科行肺切除手术的肺癌患者的临床数据。所有患者术前暂停口服抗血小板药物至少5 d。主要研究终点是院内的心血管并发症和死亡。 结果 本研究共纳入111例患者。支架放置和肺癌手术间隔的时间在1个月-3个月、3个月-12个月、超过12个月的患者分别为6.3%、13.5%和80.2%。亚肺叶切除、肺叶切除、联合肺叶切除、全肺切除以及肺叶袖式切除的患者分别为10.8%、71.2%、9.0%、2.7%和6.3%。总的心血管并发症发生率为11.6%,包括不稳定心绞痛(n=1, 0.9%)、低血压(n=1, 0.9%)、充血性心力衰竭(n=2, 1.8%)和新发心房纤颤(n=10, 9.0%)。本组病例无围手术期死亡,无主要不良心血管事件(major adverse cardiac events, MACE)。 结论 术前暂停口服抗血小板药物是安全的,围手术期未发生MACE和死亡。
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Affiliation(s)
- Weiming Huang
- Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - Kang Qi
- Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - Zhimao Chen
- Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - Jian Li
- Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
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Yeginsu A, Vayvada M, Karademir BC, Erkılınç A, Tasci AE, Buyukbayrak F, Gurcu E, Kutlu CA. Combined Off-Pump Coronary Artery Bypass Grafting and Lung Resection in Patients with Lung Cancer Accompanied by Coronary Artery Disease. Braz J Cardiovasc Surg 2019; 33:483-489. [PMID: 30517257 PMCID: PMC6257540 DOI: 10.21470/1678-9741-2018-0126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/30/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction Optimal surgical approach for the treatment of resectable lung cancer
accompanied by coronary artery disease (CAD) remains a contentious issue. In
this study, we present our cases that were operated simultaneously for
concurrent lung cancer and CAD. Methods Simultaneous off-pump coronary artery bypass surgery (OPCABG) and lung
resection were performed on 10 patients in our clinic due to lung cancer
accompanied by CAD. Demographic features of patients, operation data and
postoperative results were evaluated retrospectively. Results Mean patient age was 63.3 years (range 55-74). All patients were male. Six
cases of squamous cell carcinoma, three of adenocarcinoma and one case of
large cell carcinoma were diagnosed. Six patients had single-vessel CAD and
4 had two-vessel CAD. Three patients underwent OPCABG at first and then lung
resection. The types of resections were one right pneumonectomy, three right
upper lobectomies, one right lower lobectomy, three left upper lobectomies,
and two left lower lobectomies. Reoperation was performed in one patient due
to hemorrhage. One patient developed intraoperative contralateral tension
pneumothorax. One patient died due to acute respiratory distress syndrome at
the early postoperative period. Conclusion Simultaneous surgery is a safe and reliable option in the treatment of
selected patients with concurrent CAD and operable lung cancer.
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Affiliation(s)
- Ali Yeginsu
- Department of Thoracic Surgery, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Kartal, Istanbul, Turkey
| | - Mustafa Vayvada
- Department of Thoracic Surgery, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Kartal, Istanbul, Turkey
| | - Burcin C Karademir
- Department of Cardiovascular Surgery, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Istanbul, Turkey
| | - Atakan Erkılınç
- Department of Anesthesia and Reanimation, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Erdal Tasci
- Department of Thoracic Surgery, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Kartal, Istanbul, Turkey
| | - Fuat Buyukbayrak
- Department of Cardiovascular Surgery, Okan University School of Medicine, Istanbul, Turkey
| | - Emre Gurcu
- Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Department of Anesthesia and Reanimation, Istanbul, Turkey
| | - Cemal Asım Kutlu
- Yuzuncu Yil University School of Medicine Gaziosmanpasa Hospital, Department of Thoracic Surgery, Istanbul, Turkey
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Sandri A, Petersen RH, Decaluwé H, Moons J, Ferguson MK, Hansen HJ, Brunelli A. Coronary artery disease is associated with an increased mortality rate following video-assisted thoracoscopic lobectomy. J Thorac Cardiovasc Surg 2017; 154:352-357. [PMID: 28412122 DOI: 10.1016/j.jtcvs.2017.03.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/19/2017] [Accepted: 03/05/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To compare the incidence of major adverse cardiac events (MACE) and mortality following video-assisted thoracoscopic surgery (VATS) lobectomy in patients with and without coronary artery disease (CAD). METHODS Multicentre retrospective analysis of 1699 patients undergoing VATS lobectomy (January 2012-March 2015). CAD definition: previous acute myocardial infarct (AMI), angina, percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). MACE definition: postoperative acute myocardial ischemia, cardiac arrest or any cardiac death. Propensity score analysis was performed to match patients with and without CAD. Outcomes of the 2 matched groups were compared. RESULTS The incidence of MACE and mortality for the entire population was 0.4% (7 patients) and 1.7% (29 patients); 218 patients (13%) had a history of CAD: 106 previous AMI, 55 angina, 32 CABG, and 81 PCI. The propensity score yielded 2 well-balanced groups of 218 pairs with and without CAD. MACE (CAD 2 [0.9%] vs no-CAD 1 [0.5%]; P = 1), cardiovascular and pulmonary complications (CAD 61 [28%] vs no-CAD 51 [23%]; P = .3) and postoperative stay (CAD 7.3 days vs no-CAD 6.2 days; P = .3) were not different between the groups. The incidence of atrial fibrillation (CAD 31 [14%] vs no-CAD 18 [8.2%]; P = .07), 30-day mortality (CAD: 11 [5%] vs no-CAD 2 [0.9%]; P = .02) and death among complicated patients (CAD 18% vs no-CAD 3.9%; P = .009) were higher in the CAD group. CONCLUSIONS The incidence of MACE following VATS lobectomy in patients with CAD is low and similar to patients without CAD. However, their risk of postoperative mortality is fivefold higher compared with non-CAD patients, warranting refined preoperative functional evaluation and more intense postoperative monitoring.
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Affiliation(s)
- Alberto Sandri
- Department of Thoracic Surgery, St James's University Hospital, Leeds, United Kingdom
| | | | | | - Johnny Moons
- Department of Thoracic Surgery UZ Leuven, Leuven, Belgium
| | - Mark K Ferguson
- Department of Surgery and The Comprehensive Cancer Center, The University of Chicago, Chicago, Ill
| | - Henrik Jessen Hansen
- Department of Cardio-thoracic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Alessandro Brunelli
- Department of Thoracic Surgery, St James's University Hospital, Leeds, United Kingdom.
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Abstract
Locally advanced lung cancer remains a surgical indication in selected patients. This condition often demands larger resections. As a consequence preoperative functional workup is of paramount importance to stratify the risk and choose the most appropriate treatment. We reviewed the current evidence on functional evaluation with a special focus on specific aspects related to locally advanced lung cancer stages (i.e., risk after neoadjuvant treatment, pneumonectomy). Evidence is discussed to provide information that could assist clinicians in their preoperative workup of these challenging patients.
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Bablekos GD, Analitis A, Michaelides SA, Charalabopoulos KA, Tzonou A. Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:213. [PMID: 27386487 DOI: 10.21037/atm.2016.06.02] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Co-morbidity of primary lung cancer (LC) and heart disease (HD), both requiring surgical therapy, characterizes a high risk group of patients necessitating prompt diagnosis and treatment. The aim of this study is the review of available evidence guiding the management of these patients. METHODS Postoperative outcome of patients operated for primary LC (first meta-analysis) and for both primary LC and HD co-morbidity (second meta-analysis), were studied. Parameters examined in both meta-analyses were thirty-day postoperative mortality, postoperative complications, three- and five-year survival probabilities. The last 36 years were reviewed by using the PubMed data base. Thirty-seven studies were qualified for both meta-analyses. RESULTS The pooled 30-day mortality percentages (%) were 4.16% [95% confidence interval (CI): 2.68-5.95] (first meta-analysis) and 5.26% (95% CI: 3.47-7.62) (second meta-analysis). Higher percentages of squamous histology and lobectomy, were significantly associated with increased (P=0.001) and decreased (P<0.001) thirty-day postoperative mortality, respectively (first meta-analysis). The pooled percentages for postoperative complications were 34.32% (95% CI: 24.59-44.75) (first meta-analysis) and 45.59% (95% CI: 35.62-55.74) (second meta-analysis). Higher percentages of squamous histology (P=0.001), lobectomy (P=0.002) and p-T1 or p-T2 (P=0.034) were associated with higher proportions of postoperative complications (second meta-analysis). The pooled three- and five- year survival probabilities were 68.25% (95% CI: 45.93-86.86) and 52.03% (95% CI: 34.71-69.11), respectively. Higher mean age (P=0.046) and percentage lobectomy (P=0.009) significantly reduced the five-year survival probability. CONCLUSIONS Lobectomy and age were both accompanied by reduced five-year survival rate. Also, combined aorto-coronary bypass grafting (CABG) with lobectomy for squamous pT1 or pT2 LC displayed a higher risk of postoperative complications. Moreover, medical decision between combined or staged surgery is suggested to be individualized based on adequacy of coronary arterial perfusion, age, patient's preoperative performance status (taking into account possible co-morbidities per patient), tumor's staging and extent of lung resection.
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Affiliation(s)
- George D Bablekos
- 1 Technological Educational Institute of Athens, Faculty of Health and Caring Professions, Agiou Spyridonos, 12243, Egaleo, Athens, Greece ; 2 Department of Physiology, Medical School, Democritus University of Thrace, Dragana 68100, Alexandroupolis, Greece ; 3 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527, Goudi, Athens, Greece ; 4 Department of Occupational Lung Diseases and Tuberculosis, "Sismanogleio" General Hospital, 15126, Maroussi, Athens, Greece
| | - Antonis Analitis
- 1 Technological Educational Institute of Athens, Faculty of Health and Caring Professions, Agiou Spyridonos, 12243, Egaleo, Athens, Greece ; 2 Department of Physiology, Medical School, Democritus University of Thrace, Dragana 68100, Alexandroupolis, Greece ; 3 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527, Goudi, Athens, Greece ; 4 Department of Occupational Lung Diseases and Tuberculosis, "Sismanogleio" General Hospital, 15126, Maroussi, Athens, Greece
| | - Stylianos A Michaelides
- 1 Technological Educational Institute of Athens, Faculty of Health and Caring Professions, Agiou Spyridonos, 12243, Egaleo, Athens, Greece ; 2 Department of Physiology, Medical School, Democritus University of Thrace, Dragana 68100, Alexandroupolis, Greece ; 3 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527, Goudi, Athens, Greece ; 4 Department of Occupational Lung Diseases and Tuberculosis, "Sismanogleio" General Hospital, 15126, Maroussi, Athens, Greece
| | - Konstantinos A Charalabopoulos
- 1 Technological Educational Institute of Athens, Faculty of Health and Caring Professions, Agiou Spyridonos, 12243, Egaleo, Athens, Greece ; 2 Department of Physiology, Medical School, Democritus University of Thrace, Dragana 68100, Alexandroupolis, Greece ; 3 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527, Goudi, Athens, Greece ; 4 Department of Occupational Lung Diseases and Tuberculosis, "Sismanogleio" General Hospital, 15126, Maroussi, Athens, Greece
| | - Anastasia Tzonou
- 1 Technological Educational Institute of Athens, Faculty of Health and Caring Professions, Agiou Spyridonos, 12243, Egaleo, Athens, Greece ; 2 Department of Physiology, Medical School, Democritus University of Thrace, Dragana 68100, Alexandroupolis, Greece ; 3 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527, Goudi, Athens, Greece ; 4 Department of Occupational Lung Diseases and Tuberculosis, "Sismanogleio" General Hospital, 15126, Maroussi, Athens, Greece
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