Isomura T, Hisatomi K, Koga M, Yamana K, Kinoshita H, Kosuga K, Oishi K
Second Department of Surgery, Kurume University Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1991 Jul;92(7):847-51.
During the last two years and six months, ten patients underwent operation for both coronary artery disease and non-cardiac surgery. There were six patients with vascular disease, three with gastric cancer and one with cholelithiasis. Six patients had simultaneous operation of both coronary artery bypass grafting (CABG) and non-cardiac surgery, and four underwent non-cardiac surgery mean of 105 days after CABG. The number of significant lesions of coronary artery in patients with simultaneous or two-staged operation was 2.2 +/- 0.8 or 2.8 +/- 0.5 per patient, respectively. The operative time in patients with simultaneous operation was 361 +/- 49 minutes. However, in patients with staged operation the time for cardiac surgery was 380 +/- 36 minutes and the time for non-cardiac operation was 388 +/- 83 minutes. There were no patients with complications after either cardiac or non-cardiac operation. In patients having surgical indications for both coronary artery and non-cardiac diseases, CABG should be performed prior to the non-cardiac surgery. In patients with normal cardiac function and sufficient operative time after CABG, concomitant operation seemed to be recommended. In case with advanced malignant disease or incompetent cardiac function, staged operation would be selected for good surgical result.
在过去两年半的时间里，10例患者接受了冠状动脉疾病和非心脏手术。其中6例患有血管疾病，3例患有胃癌，1例患有胆结石。6例患者同时进行了冠状动脉旁路移植术（CABG）和非心脏手术，4例在CABG术后平均105天接受了非心脏手术。同期或分期手术患者的冠状动脉严重病变数量分别为每位患者2.2±0.8或2.8±0.5。同期手术患者的手术时间为361±49分钟。然而，分期手术患者的心脏手术时间为380±36分钟，非心脏手术时间为388±83分钟。心脏或非心脏手术后均无患者出现并发症。对于同时患有冠状动脉疾病和非心脏疾病且有手术指征的患者，应在非心脏手术前进行CABG。对于心脏功能正常且CABG术后有足够手术时间的患者，似乎建议进行同期手术。对于晚期恶性疾病或心脏功能不全的患者，为了获得良好的手术效果，应选择分期手术。
