Should Cardiac Surgery and Lung Cancer Be Operated Simultaneously?
Keywords: Lung cancer, cardiac surgery, cardiopulmonary surgery, concomitant heart lung operation
Introduction: There are limited studies regarding the concomitant surgical outcomes of resectable lung cancer (LC) and cardiac surgery (CS). This study aims to present the outcomes of cases with major pulmonary resection due to LC and CS that were operated upon simultaneously, and also present the literature associated with this procedure. Patients and Methods: From October 2011 to May 2019, 10 LC patients (8 men, 2 women) who had undergone concomitant CSs were included in the study. The median age of the patients was 67 years (43-78). All patients underwent sternotomy, with left thoracotomy added after sternotomy for 1 left lower lobe tumour. Cardiac operations were performed for coronary artery problems in 7 cases, for aorta stenosis of 1 case, for mitral stenosis for 1 case and for an intra-atrial mass in 1 case. Results: No mortality was observed in the early period. Re-operation linked to postoperative haemorrhage was not encountered. The most common complication was atrial fibrillation, which was seen in 3 cases. Nine cases underwent lobectomy, with 1 case undergoing bilobectomy. Four cases had adenocarcinoma, 2 cases had squamous cell carcinoma, 1 case had small cell carcinoma, 1 case had large cell carcinoma, 1 case had undifferentiated round cell carcinoma, and 1 case had atypical carcinoid tumour. The median duration of hospital stay was 5.5 days (4-10). Median follow-up was 74 months (1-91), with mortality observed in a total of 3 cases (30%); 2 due to recurrence and 1 due to cardiac arrest. Seven cases were tumour-free. Conclusion: When limited cases studies and previous literature were investigated, the concomitant LC and CS method was observed to result in the highest number of appropriate, reliable and satisfactory outcomes.