Impact of coronary artery disease on outcomes of video-assisted thoracoscopic surgery for non-small cell lung cancer: A retrospective analysis
Sevinc Citak1, Ertan Sarıbaş2, Gonca Geçmen3, Fatma Feyza Alkilic1, Murat Ersin Çardak1, Busra Yaprak Bayrak41Department of Thoracic Surgery, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Türkiye2Department of Pulmonology, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Türkiye
3Department of Pathology, Kartal Dr Lutfi Kirdar City Hospital, Istanbul, Türkiye
4Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
INTRODUCTION: Coronary artery disease (CAD) is a prevalent comorbidity among patients undergoing lung cancer surgery, posing significant perioperative challenges. Video-assisted thoracoscopic surgery (VATS) has gained prominence for its minimally invasive approach and reduced morbidity compared to open thoracotomy. This study investigates the outcomes of VATS in patients with non-small cell lung cancer (NSCLC) and concomitant CAD.
METHODS: This retrospective study analyzed 42 patients with NSCLC who underwent VATS anatomical resections at Kartal Kosuyolu High Specialization Education & Research Hospital from April 2020 to August 2024. Patients were divided into two groups: the study group included those with a history of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), while the control group comprised patients without such histories. All patients underwent preoperative cardiac evaluations and tailored antithrombotic management. Outcomes were assessed in terms of perioperative complications, postoperative recovery, and pathological findings.
RESULTS: The study group (n=20) and control group (n=22) were comparable in terms of demographics and tumor characteristics. The mean operative time was 312 minutes for the study group and 330 minutes for the control group. Drain removal time and hospital stay were slightly longer in the study group. Post-operative cardiovascular complications were minimal, with no significant differences between groups. Pathological evaluation revealed similar tumor histology and staging, predominantly adenocarcinoma in both groups. VATS demonstrated low conversion rates and acceptable outcomes, even in high-risk patients with CAD.
DISCUSSION AND CONCLUSION: VATS is a feasible and safe surgical option for NSCLC patients with concomitant CAD. With appropriate preoperative evaluations and individualized management, perioperative risks can be minimized, enabling effective surgical treatment for this complex patient population.
Manuscript Language: English