Kohno H, Nakashima A, Matsui K, Kurisu K, Sakamoto M, Murakami S, Ashihara T, Fukuyama T, Takenaka M, Fujinaga Y
Kyobu Geka. 1989 Nov;42(12):1005-8.
Two patients with coronary artery disease required operation for gastric cancer. In one patient with single vessel disease, 37 days later after successful PTCA, gastric resection for early gastric cancer was performed without any cardiac complication. The other patient with severe three vessel disease initially underwent coronary artery bypass operation, and 13 days later gastric resection for advanced cancer was performed. This patient developed supraventricular arrhythmia as a sole complication which was easily controlled by medical treatment. In both cases, fentanyl was used as an anesthetic agent and nitroglycerin was continuously administered intravenously during the perioperative period. ECG, central venous pressure, and direct arterial pressure were also carefully monitored. We feel that noncardiac operation such as gastric resection can be performed without major cardiac complications even shortly after coronary artery bypass operation.
两名冠心病患者因胃癌需要手术。一名单支血管病变患者在成功进行经皮冠状动脉腔内血管成形术(PTCA)37天后,接受了早期胃癌胃切除术,未出现任何心脏并发症。另一名严重三支血管病变患者最初接受了冠状动脉搭桥手术,13天后进行了进展期癌症胃切除术。该患者出现室上性心律失常这一唯一并发症,通过药物治疗很容易得到控制。在这两例手术中,均使用芬太尼作为麻醉剂,围手术期持续静脉输注硝酸甘油。同时还仔细监测心电图、中心静脉压和直接动脉压。我们认为,即使在冠状动脉搭桥手术后不久,像胃切除术这样的非心脏手术也可以在不出现重大心脏并发症的情况下进行。