Figure 2. Angiography.
After two months, patient have returned to clinic giving a consent to
perform a simultaneous surgery. The patient was stable with no changes
in condition, lab and instrumental analysis.
After preparation patient underwent simultaneous surgery: CABG with
cardiac pulmonary bypass. Laparoscopic anterior resection of rectum.
Firstly, a team of cardiac surgeons performed CABG: mammary-coronary
bypass of LAD, autovenous bypass of obtuse marginal artery, posterior
interventricular artery. Time of cardiopulmonary bypass – 48 minutes,
cross – 20 minutes. Blood loss – 200 ml.
After that, a team of general surgeons performed laparoscopic anterior
resection of rectum with anastomosis.
The tumor size was 5x6x7 cm, the specimen was resected within the limits
established by oncologic protocols (Figure 3). After a total 310 minutes
of surgery patient was transferred to ICU without inotropic support and
extubated 7 hours after the surgery. Patient was closely monitored in
ICU for 1 day and transferred to surgical ward.