Introduction
Gastric cancer and colorectal malignancies, two major cancers that
threaten human life, rank sixth and second in terms of global incidence
of cancer, respectively, and gastric cancer ranks second in terms of
mortality 1. Cardiovascular disease is the most common
risk factor that complicates the radical resection of gastrointestinal
tumors in elderly patients 2. In recent years, with
the development of the economy and improvement in health care within
China, the average life span has been significantly extended3. At the same time, the incidence of cardiovascular
diseases has also increased significantly 4. The
number of patients with ischemic heart disease, especially those with
multiple coronary arteries severely affected by stenosis, has gradually
increased 5. As such, the number of patients with
gastrointestinal tumors complicated by multi-vessel coronary artery
disease is also trending upwards.
Studies have confirmed that the incidence of perioperative myocardial
ischemia is approximately 40% for non-cardiac surgery in cardiovascular
patients/high-risk patients, which is nine times higher than low-risk
patients, and postoperative negative cardiac events are significantly
increased 6. Patients with coronary heart disease,
especially those with multiple vessels affected, who only undergo
peripheral vascular, chest and abdominal surgery without coronary
revascularization, have an increased risk of myocardial infarction and
cardiac death 7. Coronary revascularization can help
reduce the risk of heart attack and death in these high-risk patients8. Therefore, for patients with gastrointestinal
cancer complicated by severe coronary artery stenosis, it has become a
difficult surgical problem to achieve complete radical resection of the
tumor while reducing the risk, as much as possible, of perioperative
myocardial infarction and death. This study retrospectively analyzed the
data of five patients who underwent concurrent off-pump coronary artery
bypass (OPCAB) and radical resection of a gastrointestinal tumor between
September 2010 and October 2019, in order to provide additional insight
regarding the treatment of these patients.