What does this research mean for the field?

Off-pump CABG combined with gastrointestinal cancer resection is safe and feasible, with no perioperative infections or cardiac adverse events during follow-up. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study investigates the safety and feasibility of surgical interventions for patients with severe coronary artery disease and gastrointestinal malignancies.

January 10, 2026European journal of medical research0 citationsOpen Access

Feasibility and safety of surgery for coronary artery disease and gastrointestinal malignancy: a propensity score matching analysis

SCShi‐Lun Cai MZMingkui Zhang YJYuheng Jiang

Key Result

Off-pump CABG combined with gastrointestinal cancer resection was found to be safe and feasible, with no perioperative infections or cardiac adverse events in follow-up.

Key Points

This study investigates the safety and feasibility of surgical interventions for patients with severe coronary artery disease and gastrointestinal malignancies.
Performed a propensity score matching analysis to balance characteristics between treatment groups.
Conducted surgical treatments on eight patients with severe CAD and gastrointestinal cancer.
Compared outcomes, including survival and cardiac events, between the CABG and CABG + tumor resection groups.
Eight patients received surgery without significant complications or infections.
No significant differences in perioperative factors between CABG and CABG + tumor resection groups were noted.
At follow-up, most patients had no tumor recurrence or cardiac events, indicating favorable outcomes.

Structured PICO

Does off-pump CABG combined with gastrointestinal tumor resection increase perioperative complications compared to isolated off-pump CABG in patients with severe CAD?

Population

75 patients (8 with severe CAD and gastrointestinal cancer, 67 with isolated severe CAD) from a single center in China. Mean age 59.66-64.50 years, 87.5-88.1% male.

Intervention

Off-pump coronary artery bypass grafting (CABG) combined with gastrointestinal cancer radical resection (single stage or staged)

Comparator

Isolated off-pump coronary artery bypass grafting (CABG), matched 1:1 using propensity scores

Outcome

Perioperative outcomes including 24-h drainage, intraoperative blood transfusion, ventilator support time, ICU stay duration, postoperative hospital stay duration, perioperative myocardial infarction, stroke, and ARDSsafety

Off-pump CABG combined with gastrointestinal cancer radical surgery is safe and feasible for patients with severe CAD and gastrointestinal tumors, without significantly increasing perioperative complications.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background The treatment strategy for severe coronary artery disease (CAD) combined with gastrointestinal malignant tumors remains controversial. This study aimed to explore the feasibility and safety of surgical treatment for severe CAD and gastrointestinal malignant tumors. Materials and methods From January 2018 to May 2025, eight patients with severe CAD and gastrointestinal cancer underwent surgical treatment at our institution. A propensity score matching analysis was performed to balance baseline characteristics between the CABG group (group 1) and the CABG + tumor resection (TR) group (group 2). The surgical procedures and preliminary outcomes of both groups were compared, along with survival status and cardiac adverse events during follow-up. Results Eight cases of gastrointestinal malignant tumors combined with CAD were identified, with seven patients undergoing off-pump CABG and gastrointestinal cancer radical resection in single stage or staged (one case received chemotherapy). 67 cases of isolated off-pump CABG were subjected to propensity score matching analysis, with a 1:1 matching ratio to compare perioperative outcomes between the two groups. Patients were followed up for postoperative cardiac adverse events, tumor recurrence, and survival time. Except for surgical duration, there were no significant differences between the two groups in 24-h drainage, intraoperative blood transfusion, ventilator support time, ICU stay duration, postoperative hospital stay duration, perioperative myocardial infarction, stroke, and ARDS ( p > 0.05). All patients were discharged in good condition, without perioperative infections, or anastomotic leaks. At follow-up ranging from 2 to 45 months (mean 19 months), one colorectal cancer patient died suddenly during chemotherapy 15 months postoperatively, and one gastric lymphoma patient died from lymphoma recurrence 41 months postoperatively. The remaining patients did not experience tumor recurrence or metastasis, and no cardiac adverse events occurred. Conclusions For patients with severe CAD and gastrointestinal tumors, Off-Pump CABG and gastrointestinal cancer radical surgery is safe and feasible. Selecting appropriate patients for surgery can achieve good clinical outcomes.

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