Perioperative management for patients with thoracoscopic radical resection of lung cancer at two weeks after stent implantation for coronary heart disease
10.7619/jcmp.201807004
- VernacularTitle:冠心病支架植入术后2周行胸腔镜下肺癌根治术的围术期处理体会
- Author:
Fang ZHANG
1
;
Kai XU
;
Qingjun YOU
;
Jing GUO
Author Information
1. 江南大学附属医院
- Keywords:
coronary stent implantation;
radical resection of lung cancer;
thoracoscope;
anti-coagulation therapy
- From:
Journal of Clinical Medicine in Practice
2018;22(7):16-18
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the safety and feasibility of thoracoscopic radical resection of lung carcer in patients with severe coronary stenosis at 2 weeks after stent implantation.Methods Clinical materials of 13 patients with thoracoscopic radical resection of lung cancer at 2 weeks after stent implantation for coronary heart disease were analyzed retrospectively,and were compared with the clinical materials of 127 patients without severe coronary artery stenosis by thoracoscopic radical resection for lung cancer.Results Totally 13 patients in PCI group were implanted with 25 stents.Among them,12 stents were smoothly implanted in left anterior descending branch,6 stents in left circumflex branch and 7 stents in right coronary artery.The degree of coronary artery stenosis decreased from more than 75％ to less than 10％.The patients in two groups were smoothly performed thoracoscopic radical resection of lung cancer under general anesthesia,and postoperative pathology was confirmed as malignant tumor.Blood coagulation time (TT) in PCI group was significantly longer than that in the control group (P ＜ 0.05),platelet count (PLT) decreased significantly when compared with the control group (P ＜ 0.05),and the prothrombin time (PT) and activated partial thromboplastin time (APTT) showed no significant differences between two groups (P ＞ 0.05).The operating time and the bleeding volume in two groups showed no significant differences (P ＞ 0.05),while the postoperative pleural drainage in PCI group significantly increased (P ＜ 0.05),extubation time and postoperative hospitalization time were significantly longer than those in the control group (P ＜ 0.05),but in PCI group,there was no massive bleeding during and after operation,and no major cardiovascular accident occurred.Conclusion It is safe and feasible to use thoracoscopic radical surgery of lung cancer at 2 weeks after coronary artery stent implantation on the premise of standardized anticoagulant drugs and good perioperative jobs.
