Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients

Simultaneous surgery for coexisting heart disease and non-cardiac malignancy: assessment of feasibility in case series

We present case series of simultaneous surgery for coexisting cardiac and non-cardiac pathologies to evaluate the feasibility of the treatment. The retrospective analysis included 27 patients aged between 28 and 74 years. The most often heart diseases were coronary arterial disease and valve defects, and the most often heart surgery was coronary artery bypass grafting. The non-cardiac diseases included neoplasms in the abdominal cavity, urinary system, and chest organs. The average duration of surgery was 277 ± 87 minutes, blood loss 285 ± 182 ml. The in-hospital mortality was 0%, with median stay of 2 and 12 days in the intensive care unit (ICU) and emergency room, respectively. The 1 and 5-year survival rates were 85.7% and 76.2%, respectively. Simultaneous surgeries can be a treatment of choice for patients with cardiac pathology and concomitant neoplasm in abdominal, thoracic, or urinary system. This is the first such study conducted in the Central-Asian region and, in particular, in Kazakhstan.

Esophagectomy combined with off-pump coronary artery bypass grafting through left posterolateral incision is safe and feasible for esophageal cancer associated with coronary artery disease

Controversy still exists as to whether surgical treatment has any impact on the long-term survival of esophageal cancer (EC) patients with coronary artery disease treated with curative esophagectomy combined with off-pump coronary artery bypass grafting (OPCABG). Therefore, the aim of this study was to introduce and assess the effect of esophagectomy combined with OPCABG on both short- and long-term outcomes. From January 2010 to January 2015, 1428 EC or esophagogastric junction cancer patients underwent surgical treatment at Henan Chest Hospital, Zhengzhou, China. The clinical data of 25 patients who underwent EC resection through a left thoracotomy following OPCABG and the perioperative characteristics and follow-up results were analyzed. The majority of the patients were male, and the EC stage was predominantly cT2N0-1M0 II. The most common pathological types were squamous cell carcinoma. The EC surgeries consisted of 15 chest anastomosis procedures and 10 cervical anastomosis procedures with aortocoronary graft implantation (mean: 2.36 grafts per patient). The mean total operative time was 330.8 ± 83.5 minutes. The median intensive care unit and hospital lengths of stay were 1.72 and 21.16 days, respectively. Resection without macroscopic residual disease (R0) was achieved in all of the patients. The most frequent complications included pulmonary infections (24%), arrhythmias (24%), pleural effusion (12%), and esophageal anastomotic leakage (8%). There were no postoperative deaths or myocardial infarctions within 30 days after the surgery. The overall 1-, 3-, and 5-year survival rates were 88%, 40%, and 24%, respectively, with a median survival time of 43 months. In the short-term, radical resection of EC following OPCABG is a safe and feasible treatment with low postoperative mortality rates. In the long-term, simultaneous surgery is acceptable and is associated with favorable overall and disease-free survival.

Simultaneous coronary artery disease and achalasia surgery: A novel approach

A 69-year-old female patient presented to cardiac surgery department with unstable angina due to severe coronary artery disease. Coronary artery bypass grafting was indicated; however, the patient's symptoms of achalasia, previously treated by the pneumatic dilatation, exacerbated. Subsequently, the patient underwent simultaneous surgery. After sternotomy, on cardiopulmonary bypass, esophagus was exposed and Heller myotomy was performed. Following cardioplegia, coronary artery bypass grafting was completed. The postoperative course was uneventful, and the patient was discharged on postoperative Day 9. In conclusion, this novel surgical technique can be effectively used in such cases.

miR-339-5p Inhibits Autophagy to Reduce the Resistance of Laryngeal Carcinoma on Cisplatin via Targeting TAK1

Laryngeal carcinoma is a malignant disease with high morbidity and mortality. Several studies have indicated that miRNA dysfunction involves in the development of laryngeal carcinoma. In this study, the connection of miR-339-5p and laryngeal carcinoma was investigated, and qRT-PCR, CCK-8, and flow cytometry assay were used to observe the function of miR-339-5p on laryngeal carcinoma. Besides, the target database, dual-luciferase reporter assay, and western blot were used to explore the regulation mechanism of miR-339-5p on the progression of laryngeal carcinoma. The results showed that miR-339-5p was significantly downregulated in cisplatin-resistant cells of laryngeal carcinoma, and miR-339-5p upregulation could weaken the resistance of laryngeal carcinoma cells on cisplatin. Moreover, miR-339-5p could directly react with 3'-UTR of TAK1, and TAK1 could reverse the effects of miR-339-5p on the progression of autophagy. In conclusion, this study suggests that miR-339-5p can inhibit the autophagy to decrease the cisplatin resistance of laryngeal carcinoma via targeting TAK1.