Department of Cardiothoracic and Vascular Surgery, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany.
Langenbecks Arch Surg. 2013 Aug;398(6):903-7. doi: 10.1007/s00423-013-1081-6. Epub 2013 Jun 13.
The aim of this study was to evaluate the impact of previous cardiovascular surgery on the postoperative morbidity and mortality following major pulmonary resection for non-small cell lung cancer (NSCLC).
Medical records of 227 patients, who underwent major pulmonary resection for NSCLC from 2003 to 2012 at our department, were reviewed retrospectively. Thirty-one patients with a mean age of 65.8 years had previous cardiovascular surgery (group A) including coronary artery revascularization in 11 patients, peripheral arterial revascularization in 6 patients, carotis endarterectomy in 9 patients, and combined coronary artery revascularization and carotis endarterectomy in 5 patients, whereas 167 patients (mean age = 62.0 years) had no cardiovascular comorbidity (group B). Twenty-nine patients with nonsurgically treated cardiovascular comorbidity were excluded from this study.
There were no significant differences in overall postoperative morbidity (22.6 % in group A vs. 19.2 % in group B) and mortality (no mortality in group A vs. 2.4 % in group B) between both groups.
Major pulmonary resections for NSCLC can be performed safely in patients with previous cardiovascular surgical history who are fulfilling the common cardiopulmonary criteria of operability. Operative risk in this subpopulation is comparable to that in patients without cardiovascular comorbidity.
本研究旨在评估非小细胞肺癌（NSCLC）患者行大肺切除术时，既往心血管手术对术后发病率和死亡率的影响。
回顾性分析 2003 年至 2012 年在我科行大肺切除术治疗 NSCLC 的 227 例患者的病历。31 例平均年龄 65.8 岁的患者有既往心血管手术史（A 组），包括 11 例冠状动脉血运重建术、6 例外周动脉血运重建术、9 例颈动脉内膜切除术和 5 例冠状动脉血运重建术和颈动脉内膜切除术；167 例（平均年龄 62.0 岁）无心血管合并症（B 组）。本研究排除了 29 例未经手术治疗的心血管合并症患者。
两组患者的总体术后发病率（A 组 22.6%，B 组 19.2%）和死亡率（A 组无死亡，B 组 2.4%）无显著差异。
满足一般心肺手术可操作性标准的既往有心血管手术史的 NSCLC 患者，行大肺切除术是安全的。该亚群的手术风险与无心血管合并症的患者相当。
