Tevfik Ilker Akcam1, Ozgur Samancilar2, Serkan Yazgan2, Kenan Can Ceylan2, Celalettin Ibrahim Kocaturk3, Celal Bugra Sezen3, Cagatay Salim Tezel4, Deniz Gurer4, Ahmet Sami Bayram5, Huseyin Melek5, Berker Ozkan6, Melike Guler Ulker6, Erkan Kaba7, Alper Toker8. 1. Department of Thoracic Surgery, School of Medicine, Ege University, Izmir, Turkey. Electronic address: tevfikilkerakcam@hotmail.com. 2. Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey. 3. Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. 4. Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. 5. Department of Thoracic Surgery, School of Medicine, Uludag University, Bursa, Turkey. 6. Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey. 7. Department of Thoracic Surgery, Istanbul Bilim University Medical Faculty and Group Florence Nightingale Hospitals, Istanbul, Turkey. 8. Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey; Department of Thoracic Surgery, Istanbul Bilim University Medical Faculty and Group Florence Nightingale Hospitals, Istanbul, Turkey.
Abstract
BACKGROUND: Lung cancer surgery may be required for patients with a history of coronary artery bypass graft (CABG). In this study, we evaluated the general characteristics of patients, the difficulties experienced during and after lung cancer surgery and complications and mortality rates. METHOD: Patients who were operated on for primary lung cancer between January 2012 and July 2017 in the participating centres were analysed retrospectively (n=7,530). Patients with a history of CABG (n=220) were examined in detail. This special group was analysed and compared with other patients operated on for lung cancer who did not have CABG (n=7,310) in terms of 30-day mortality and revision for haemorrhage. RESULTS: Of the 7,530 patients operated on for primary lung cancer, 2.9% were found to have undergone CABG. Surgical revision was required in the early postoperative period for 6.8% of those who had CABG and 3.5% in those who did not have CABG (p=0.009). Thirty-day (30-day) mortality was 4.5% in those who had CABG and 2.9% in those who did not have CABG (p=0.143). Further analysis of patients who had undergone CABG demonstrated that video-assisted thoracoscopic surgery (VATS) resulted in fewer complications (p=0.015). Patients with a left-sided left internal mammary artery (LIMA) graft had a higher number of postoperative complications (p=0.30). CONCLUSIONS: Patients who had CABG suffered postoperative haemorrhage requiring a revision twice as often, and a tendency towards higher mortality (non-statistically significant). In patients with a history of CABG, VATS was demonstrated to have fewer complications. Patients with a LIMA graft who had a left-sided resection had more postoperative complications.
BACKGROUND:Lung cancer surgery may be required for patients with a history of coronary artery bypass graft (CABG). In this study, we evaluated the general characteristics of patients, the difficulties experienced during and after lung cancer surgery and complications and mortality rates. METHOD:Patients who were operated on for primary lung cancer between January 2012 and July 2017 in the participating centres were analysed retrospectively (n=7,530). Patients with a history of CABG (n=220) were examined in detail. This special group was analysed and compared with other patients operated on for lung cancer who did not have CABG (n=7,310) in terms of 30-day mortality and revision for haemorrhage. RESULTS: Of the 7,530 patients operated on for primary lung cancer, 2.9% were found to have undergone CABG. Surgical revision was required in the early postoperative period for 6.8% of those who had CABG and 3.5% in those who did not have CABG (p=0.009). Thirty-day (30-day) mortality was 4.5% in those who had CABG and 2.9% in those who did not have CABG (p=0.143). Further analysis of patients who had undergone CABG demonstrated that video-assisted thoracoscopic surgery (VATS) resulted in fewer complications (p=0.015). Patients with a left-sided left internal mammary artery (LIMA) graft had a higher number of postoperative complications (p=0.30). CONCLUSIONS:Patients who had CABG suffered postoperative haemorrhage requiring a revision twice as often, and a tendency towards higher mortality (non-statistically significant). In patients with a history of CABG, VATS was demonstrated to have fewer complications. Patients with a LIMA graft who had a left-sided resection had more postoperative complications.