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Updated: Aug 14, 2026
Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
Published on: December 27, 2024
Surgery for gastric cancer combined with cardiac and aortic surgery
Yoshihiko Tsuji1, Naoto Morimoto, Hiroshi Tanaka
1Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. ytsuji@med.kobe-u.ac.jp
Insights
The stage of gastric cancer significantly impacts survival for patients needing surgery for both heart or aortic conditions and cancer. Early-stage gastric cancer offers a better prognosis.
Area of Science:
- Cardiovascular Surgery
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Simultaneous treatment of cardiac/aortic diseases and gastric cancer presents complex therapeutic challenges.
- Identifying prognostic factors is crucial for optimizing patient outcomes in this high-risk group.
Purpose of the Study:
- To evaluate the prognostic factors and survival rates in patients undergoing surgical intervention for concurrent gastric cancer and cardiac or aortic diseases.
- To clarify therapeutic strategies for this complex patient population.
Main Methods:
- Retrospective review of 14 patients treated between 2000 and 2004 at a tertiary referral university hospital.
- Analysis included patients with coronary artery disease, thoracic aortic aneurysms, or abdominal aortic aneurysms undergoing concurrent or staged procedures with gastric cancer surgery.
Main Results:
- Overall survival rates were 76.6% at 1 year and 68.1% at 3 years.
- One-year survival was 90.0% for early-stage (I/II) gastric cancer and 50.0% for advanced-stage (III/IV) gastric cancer.
- One hospital death occurred; no prosthetic graft infections were observed.
Conclusions:
- The clinical stage of gastric cancer is the primary determinant of prognosis in patients with combined cardiac/aortic and gastric pathologies.
- Staged procedures were more common (10/14 patients), suggesting a cautious approach to managing these complex cases.
Hypothesis:
Therapeutic strategies for patients who require procedures for both cardiac or aortic diseases and gastric cancer are controversial. Prognostic factors for them should be clearly identified.
Design:
Retrospective review of 14 patients who underwent surgical intervention for both gastric cancer and cardiac or aortic diseases between January 1, 2000, and June 30, 2004.
Setting:
Tertiary referral university hospital.
Patients:
Cardiac and aortic diseases included coronary artery disease in 5 patients, thoracic aortic aneurysms in 3 patients, and abdominal aortic aneurysms in 6 patients. Coronary artery bypass graftings were performed with an off-pump procedure, and aneurysms were replaced with prosthetic grafts in all of the cases. The surgical stages of gastric cancers were stage I in 8 patients, stage II in 2 patients, stage III in 3 patients, and stage IV in 1 patient. According to our original therapeutic strategies, 4 patients underwent simultaneous procedures and 10 received staged procedures.
Main Outcome Measure:
Overall survival rates.
Results:
There was 1 hospital death caused by multiple organ failure. No prosthetic graft infection was noted. Thirteen patients were discharged, and 3 died of cancer recurrence during an average follow-up period of 26.3 months. The cumulative survival rate was 76.6% at 1 year and 68.1% at 3 years. One-year survival rates were 90.0% in stages I and II gastric cancer and 50.0% in stages III and IV gastric cancer.
Conclusion:
Prognosis of patients who underwent surgical intervention for both gastric cancer and cardiac or aortic diseases was mainly limited by the clinical stage of gastric cancer.
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