• Cox proportional hazards regression model
• National Health Insurance Research Database
• acarbose
• diabetes mellitus
• gastric cancer

• Humans
• Acarbose/therapeutic use
• Acarbose/administration & dosage
• Stomach Neoplasms/epidemiology
• Female
• Male
• Middle Aged
• Retrospective Studies
• Taiwan/epidemiology
• Aged
• Cohort Studies
• Adult
• Diabetes Mellitus/epidemiology
• Databases, Factual
• Proportional Hazards Models
• Hypoglycemic Agents/therapeutic use
• Hypoglycemic Agents/adverse effects
• Risk Factors
• Severity of Illness Index

• VGHKS108-D12-1 Kaohsiung Veterans General Hospital

• coronary artery disease
• mitral
• simultaneous surgeries
• stomach cancer
• valve disease

Surgery is the treatment of choice for squamous cell esophageal cancer. Complete resection of the esophagus with reconstruction of the digestive tract is performed for tumors located in the chest or cardia. The aim of the report is to present the case of a complete esophageal and gastric resection complicated by colon graft necrosis. The patient was a 45-year-old woman diagnosed with cancer of the cardia infiltrating the distal section of the esophagus and the body and fundus of the stomach. The initial surgical procedure included the opening of three body cavities followed by resection of the thoracic esophagus, stomach, and a portion of the left hepatic lobe. Right colon interposition was performed to restore digestive tract continuity. On the 8th day, a leak was observed in the esophagointestinal anastomosis. Management consisted in two surgical procedures, one of which ended in the removal of the colon patch. The fourth and final procedure was conducted after 10 months.

• complications
• esophageal cancer
• esophageal resection

The co-existence of a chondrosarcoma of the chest wall and a desmoid tumor in the gastrointestinal tract is rare. In both Polish and global literature, cases of chest wall chondrosarcomas are presented in the form of case reports. Desmoids of the gastrointestinal tract are more common; notwithstanding, their incidence in Europe is estimated at approximately 2 cases per 1 million inhabitants per year.

We present the case of a 62-year-old female patient who suffered from both a chest wall chondrosarcoma and a desmoid tumor of the intestine; both neoplasms were operated on simultaneously.

The former tumor was located in the region of the right costal margin, whereas the latter was located in the mesojejunum. The surgery was performed with two independent surgical incisions. The postoperative period was uneventful. The case is noteworthy in view of the extremely rare synchronous occurrence of the described tumors and due to the fact that any such operation requires an individualized surgical approach.

• chondrosarcoma
• desmoid tumor
• surgical treatment

AIM: To investigate the safety of performing simultaneous cardiac surgery and a resection of a gastrointestinal malignancy.

METHODS: Among 3664 elective cardiac operations performed in adults at Kagoshima University Hospital from January 1991 to October 2009, this study reviewed the clinical records of the patients who underwent concomitant cardiac surgery and a gastrointestinal resection. Such simultaneous surgeries were performed in 15 patients between January 1991 and October 2009. The cardiac diseases included 8 cases of coronary artery disease and 7 cases with valvular heart disease. Gastrointestinal malignancies included 11 gastric and 4 colon cancers. Immediate postoperative and long-term outcomes were evaluated.

RESULTS: Postoperative complications occurred in 5 patients (33.3%), including strokes (n = 1), respiratory failure requiring re-intubation (n = 1), hemorrhage (n = 2), hyperbilirubinemia (n = 1) and aspiration pneumonia (n = 1). There was 1 hospital death caused by the development of adult respiratory distress syndrome after postoperative surgical bleeding followed aortic valve replacement plus gastrectomy. There was no cardiovascular event in the patients during the follow-up period. The cumulative survival rate for all patients was 69.2% at 5 years.

CONCLUSION: Simultaneous procedures are acceptable for the patients who require surgery for both cardiac diseases and gastrointestinal malignancy. In particular, the combination of a standard cardiac operation, such as coronary artery bypass grafting or an isolated valve replacement and simple gastrointestinal resection, such as gastrectomy or colectomy can therefore be safely performed.

• Simultaneous operation
• Cardiac disease
• Gastrointestinal malignancy
• Gastric cancer
• Colon cancer

The advances in surgical techniques, resuscitation and anesthesiology support over the last years have allowed simultaneous thoracic and abdominal operations to be made for cancer and concomitant severe heart vessel disease relieving the patient from several diseases simultaneously and achieving long lasting remission or cure.

A simultaneous nephrectomy and coronary artery bypass grafting procedure through extended sternotomy is reported. A 63-year-old man with severe coronary artery disease was found to have renal carcinoma.

Postoperative pathological investigation of the tumor revealed the presence of renal cell carcinoma pT3a N0 M0, G2. Coronarography revealed advanced three-vessel coronary artery disease.

We successfully performed a simultaneous curative surgery for renal carcinoma and coronary artery bypass graft surgery under cardiopulmonary bypass using a novel technique of extended sternotomy. Simultaneous surgery thus appears to be a beneficial and safe approach for the treatment of coronary artery disease and resectable renal cancer in carefully selected patients.