Simultaneous Radical Gastrectomy and Coronary Artery Bypass Grafting: a Case Report

Abstract

Coexistence of coronary artery disease and cancer with both requiring surgical treatment at the same time is rare. A 74-year-old male underwent elective coronary artery bypass grafting for unstable angina. In preoperative workup, the patient was incidentally discovered to have anaemia secondary to occult blood loss in his stool. This led to a preoperative upper GI endoscopy which showed a gastric carcinoma. Since both conditions required surgery, it was decided to perform simultaneous coronary artery bypass grafting (CABG) followed by distal radical gastrectomy. CABG was done using lowdose heparin, and after closing sternotomy, the radical gastrectomy was performed. Postoperative recovery was uneventful, and patient was discharged in stable condition on day 14. Follow-up after 6 months revealed no recurrence. Feasibility of simultaneous CABG and gastric cancer surgery, in particular, and various management strategies, in general, is discussed.

Feasibility of radical gastrointestinal tumor resection with simultaneous off‐pump coronary artery bypass surgery for patients with severe heart problems: A retrospective cohort study from a single institutional database

“…We found that the concurrent radical resection of the gastrointestinal tumor was performed under stable hemodynamics, and the radical resection of the operation was not affected 28 . The follow-up data also suggest that the overall survival and relapse-free survival after the concurrent surgeries are equivalent to those of radical gastrointestinal surgery alone 29 .…”

“…We found that the concurrent radical resection of the gastrointestinal tumor was performed under stable hemodynamics, and the radical resection of the operation was not affected. 30 The follow-up data also suggest that the overall survival and relapse-free survival after the concurrent surgeries are equivalent to those of radical gastrointestinal surgery alone. 17 A study of concurrent surgery for gastric cancer and CABG suggested that the long-term prognosis depends on the staging status of the gastric cancer at the time of diagnosis.…”