Department of Cardiothoracic Surgery, BenQ Hospital, Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
World J Surg Oncol. 2018 Oct 24;16(1):213. doi: 10.1186/s12957-018-1512-5.
The co-incidence of esophageal cancer and coronary heart disease (CHD) is increasing in elderly patients. This study was carried out to analyze the efficiency and safety of simultaneous esophagectomy and cardiac surgery in a selected group of elderly patients.
Prospective database for coexistency of severe CHD and esophageal or esophageal-gastric junction cancer was firstly reviewed. Twenty-two patients undergoing combined surgical interventions, including first beating-heart coronary artery bypass grafting (off-pump CABG) and then esophagectomy, were involved as group A. Then, 44 patients undergoing isolated esophagectomy were selected as group B using the propensity score matching method. Data including clinic pathological characteristics and postoperative outcomes were investigated. Kaplan-Meier analysis was used.
The surgical procedure was performed through left lateral thoracotomy in all patients, except one patient in group A who received median sternotomy and left lateral thoracotomy. The operation time and blood loss were both more in group A, as a result of two operations performed at one session. Patients in both groups were followed up from 1.3 to 78.3 months. No significant between-group was found in overall survival or relapse-free survival.
The risk of simultaneous esophagectomy and cardiac surgery is not high. Despite certain differences in clinical indicators between groups, the safety of simultaneous procedures in group A is evident.
ChiCTR 1800014498 . Registered 17 January 2018.
食管癌和冠心病（CHD）在老年患者中的同时发病率正在增加。本研究旨在分析在选定的老年患者群体中同时进行食管切除术和心脏手术的效果和安全性。
首先回顾了严重 CHD 与食管或食管胃交界部癌症并存的前瞻性数据库。22 例患者接受了联合手术干预，包括首次跳动心脏冠状动脉旁路移植术（非体外循环 CABG）和随后的食管切除术，作为 A 组。然后，使用倾向评分匹配方法选择了 44 例接受单纯食管切除术的患者作为 B 组。调查了包括临床病理特征和术后结果在内的数据。采用 Kaplan-Meier 分析。
所有患者均行左侧开胸手术，A 组中仅 1 例患者行正中胸骨切开术和左侧开胸术。由于一次进行两次手术，A 组的手术时间和出血量均更多。两组患者的随访时间为 1.3 至 78.3 个月。总生存和无复发生存无显著组间差异。
同时进行食管切除术和心脏手术的风险不高。尽管两组之间在临床指标上存在一定差异，但 A 组同时进行手术的安全性是明显的。
ChiCTR1800014498。注册日期：2018 年 1 月 17 日。
