CONCOMITANT OPEN-HEART-SURGERY AND PULMONARY RESECTION FOR LUNG-CANCER

From 1979 to 1993, 79 patients underwent pulmonary resection for lung cancer and a concomitant cardiac operation using extracorporeal circul ation, There were 75 men and 4 women with a mean age of 65 years (rang e 52-77), Cardiac procedures consisted of coronary artery bypass graft ing (CABG) in 69 patients (three redos), aortic valve replacement in 7 (2 combined with CABG), mitral valve repair in 1 (combined with CABG) and other in 2, In CABG cases the mean number of distal anastomoses w as 4.0, Pulmonary resection included bilateral lobectomy in I patient, sleeve lobectomy in 3, pneumonectomy in 6, bilobectomy in 5, lobectom y in 60 and segmental resection in 4, Postoperatively 52 patients were stage I (65.8 %), 18 stage II (22.8 %) and 9 stage III a, Histology w as squamous cell carcinoma in 48 patients (61%) and adenocarcinoma In 24 patients (30 %). The hospital mortality was 6.3 % (n = 5), Re-explo ration for bleeding was necessary in seven patients, Follow-up was com plete for all patients, The estimated mean survival for all patients ( including hospital deaths) was 58 months, Two- and five-year survival rates were 62% and 42% with 45 and 22 patients, respectively, under su rveillance, Lung cancer accounted for 64% of the late deaths, We concl ude that pulmonary resection for lung cancer in patients undergoing a concomitant cardiac operation can be performed safely with low operati ve morbidity and mortality and good long-term survival.