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Table 2 Clinical data for 20 modified cases

From: The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

No.

Age/sex

Diagnosis

Planned surgery

Surgery performed (reason for modification)

Outcome one year after surgery

1

51/M

Oesophageal cancer, aortic invasion, mediastinitis

Esophagectomy, aortic replacement

Esophagectomy, intercostal muscle flap to aorta (R)

Survived

2

73/F

Lumbar spinal stenosis, diabetic gangrene, CKD on HD, CAD

Laminectomy, lower limb amputation

Lower limb amputation (R)

Survived

3

80/F

Ureteral-right iliac artery fistula, common iliac artery aneurysm

Iliac artery replacement by laparotomy

Stent graft (R)

Survived

4

46/M

Pancreatic cancer, pheochromocytoma

PD

Laparoscopic right adrenalectomy (P)

Survived, PD after one month

5

62/M

Salivary fistula and ileostomy after esophagectomy

Esophageal reconstruction by thoracotomy

Pectoralis major myocutaneous flap to prevent salivary fistula (R)

Survived

6

7/F

Tumor in left arm

Biopsy, Broviac catheter insertion, bone marrow aspiration

Biopsy (R)

Survived

7

63/M

Graft infection after aortic replacement for TAAA

Removal of graft on CPB by median sternotomy

Removal of graft without CPB by thoracotomy (R)

Survived

8

78/F

Loosening after total hip arthroplasty with screw into the pelvis

Removal of implant, debridement

Removal of implant, debridement, colostomy, sigmoidectomy (E)

Survived

9

74/M

TAAA

Aortic replacement by thoracotomy and laparotomy

Aortic replacement by laparotomy (R)

Survived

10

84/M

Bladder cancer

Laparoscopic cystectomy, ureteral fistula

Ureteral fistula (R)

Died of infection POD 25

11

66/M

Gastric cancer

Gastric wedge resection

Distal partial gastrectomy (E)

Survived

12

63/M

Liver cirrhosis, liver cancer

Radiofrequency ablation by laparotomy

Percutaneous radiofrequency ablation (R)

Survived

13

31/M

Lung injury caused by chest tube, muscular dystrophy complicated with cardiomyopathy

Repair by thoracotomy

Bronchoscopic embolization (R)

Died of heart failure POD 2

14

66/F

Aortic valve stenosis, mitral valve regurgitation, post CABG

Double valve replacement

Aortic valve replacement (R)

Died of heart failure POD 38

15

86/M

Gastric cancer, CKD on HD, paraplegia after stent grafting for TAA

Distal partial gastrectomy

Gastric wedge resection (R)

Died of heart failure POD 106

16

60/F

Lung tumor, aortic invasion

Lower lobectomy, aortic replacement

Thoracoscopic biopsy (R)

Chemotherapy, survived

17

59/M

Esophageal tumor, tracheal invasion

Esophagectomy, combined resection of trachea

Biopsy (R)

Chemotherapy and radiotherapy, survived

18

71/M

Esophageal cancer, liver cancer

Esophagectomy, partial hepatectomy

Esophagectomy (R)

Chemotherapy for liver cancer, survived

19

1/M

Functional pyloric stenosis after necrotizing enterocolitis

Pyloroplasty, closure of ileostomy, colostomy

Ileotransversostomy (R)

Survived

20

70/M

Gallbladder cancer, mitral valve regurgitation, tricuspid valve regurgitation

Extended cholecystectomy

Mitral valve replacement, tricuspid valve replacement (P)

Extended cholecystectomy at 20 months, survived

  1. Abbreviations: CABG coronary artery bypass graft, CAD coronary artery disease, CKD chronic kidney disease, CPB cardiopulmonary bypass, E changed to more expansive surgery for radical treatment, HD hemodialysis, P changed to priority surgery due to patient’s clinical condition, PD pancreaticoduodenectomy, POD postoperative day, R reduction in the procedures or changed to palliative surgery due to surgical difficulties or patient comorbidities, TAA thoracic aortic aneurysm, TAAA thoracoabdominal aortic aneurysm