Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients

ObjectiveThe 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.MethodsProspective 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.ResultsThe 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 78.3months. No significant between-group was found in overall survival or relapse-free survival.ConclusionThe 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.