Coronary artery bypass grafting in patients with chronic lymphocytic leukemia

Finck, Sanford J.; Cockerill, Kevin J.; Jeter, Joseph E.; Orszulak, Thomas A.

doi:10.1016/0003-4975(93)90032-d

Cited by 18 publications

(16 citation statements)

References 22 publications

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“…Immunologic disturbances induced by ECC, are considered to contribute to neoplastic disease spreading (101,141). However, for combined LC and cardiac surgery performed under ECC, resection of lung parenchyma is safer to be performed rather before than during CPB (13,20,21), with the exception of the left lower lobe (20), or after CPB (9,20).…”

Section: Discussionmentioning

confidence: 99%

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Bablekos¹,

Analitis²,

Michaelides³

et al. 2016

Ann. Transl. Med.

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Background: Co-morbidity of primary lung cancer (LC) and heart disease (HD), both requiring surgical therapy, characterizes a high risk group of patients necessitating prompt diagnosis and treatment. The aim of this study is the review of available evidence guiding the management of these patients.Methods: Postoperative outcome of patients operated for primary LC (first meta-analysis) and for both primary LC and HD co-morbidity (second meta-analysis), were studied. Parameters examined in both meta-analyses were thirty-day postoperative mortality, postoperative complications, three-and five-year survival probabilities. The last 36 years were reviewed by using the PubMed data base. Thirty-seven studies were qualified for both meta-analyses. Results:The pooled 30-day mortality percentages (%) were 4.16% [95% confidence interval (CI): 2.68-5.95](first meta-analysis) and 5.26% (95% CI: 3.47-7.62) (second meta-analysis). Higher percentages of squamous histology and lobectomy, were significantly associated with increased (P=0.001) and decreased (P<0.001) thirty-day postoperative mortality, respectively (first meta-analysis). The pooled percentages for postoperative complications were 34.32% (95% CI: 24.59-44.75) (first meta-analysis) and 45.59% (95% CI: 35.62-55.74) (second metaanalysis). Higher percentages of squamous histology (P=0.001), lobectomy (P=0.002) and p-T1 or p-T2 (P=0.034) were associated with higher proportions of postoperative complications (second meta-analysis). The pooled threeand five-year survival probabilities were 68.25% (95% CI: 45.93-86.86) and 52.03% (95% CI: 34.71-69.11), respectively. Higher mean age (P=0.046) and percentage lobectomy (P=0.009) significantly reduced the five-year survival probability.Conclusions: Lobectomy and age were both accompanied by reduced five-year survival rate. Also, combined aorto-coronary bypass grafting (CABG) with lobectomy for squamous pT1 or pT2 LC displayed a higher risk of postoperative complications. Moreover, medical decision between combined or staged surgery is suggested to be individualized based on adequacy of coronary arterial perfusion, age, patient's preoperative performance status (taking into account possible co-morbidities per patient), tumor's staging and extent of lung resection.

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Section: Discussionmentioning

confidence: 99%

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Bablekos¹,

Analitis²,

Michaelides³

et al. 2016

Ann. Transl. Med.

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“…Fecher et al reported a 16.6% rate of bleeding and it was the main postoperative complication they observed [14]. Finally, the prior reports cited the complication rate between 23 an 57% [12][13][14]. They concluded that long-term perioperative multidisciplinary follow up and adequate medical treatment are essential in prolonging survival [15].…”

Section: Discussionmentioning

confidence: 97%

“…Therefore, surgical strategy in patients with HM must be planned and carried out with the specific aim of decreasing postoperative complications. Previous reports concerning cardiac surgery in patients with HM demonstrated infection as the primary cause of morbidity [2,[12][13][14][15]. Some studies showed morbidity rates of between 23 and 57%.…”

Section: Discussionmentioning

confidence: 98%

Percutaneous Nephrolithotomy for Kidney Stones in Patients with Hematological Malignancy

Kuzgunbay¹,

Turunç²

2016

Ann Clin Anal Med

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ÖzetAmaç: Hematolojik kanser (HK) öyküsü olan hastalarda böbrek taşı için yapı-lan perkütan nefrolitotomi (PNL) operasyonunun sonuçlarını incelemek. Gereç ve Yöntem: Merkezimizde, 2000-2013 yılları arasında böbrek taşı tedavisi için 1700 erişkin hasta PNL operasyonuna girmiştir. 4 hasta HK öyküsüne sahipti ve bunlar HK grubu olarak çalışmaya alındı (n=4). Operasyon öyküsü, HK veya herhangi bir komorbid hastalık öyküsü bulunmayan 10 ileri yaşlı hasta (>65 yaş) kontrol grubu olarak seçildi (n=10). Cerrahi parametreler, başa-rı oranları, ek tedavi gereksinimleri ve komplikasyonlar değerlendirildi. Bulgular: İstatistiksel analizler; taş büyüklüğü, operasyon süresi, floroskopi süresi, hastanede kalış süresi, ∆Hb, kan transfüzyon oranları ve INR değerleri açısın-dan HK ve kontrol grup arasında anlamlı bir fark göstermedi (p>0.05). İstatis-tiksel analizler; başarı oranları açısından HK ve kontrol grup arasında anlamlı bir fark göstermedi (p=0.470). İstatistiksel analizler; ek tedavi gereksinimleri açısından HK ve kontrol grup arasında anlamlı bir fark göstermedi (p=0.882). Her iki grupta da major perioperatif komplikasyon gözlenmedi. Tartışma: Hematolojik kanser öyküsü olan böbrek taşı hastalarının PNL ile tedavisi uygulanabilir, güvenli ve etkilidir. Bununla beraber, operayon öncesinde Hematoloji bölümü ile yakın kooperasyon gerekmektedir. Anahtar KelimelerPerkütan Nefrolitotomi; Böbrek Taşları; Hematolojik Kanserler Abstract Aim: To define the alterations in the outcomes of percutaneous nephrolithotomy (PNL) operations for kidney stones in patients with history of hematological malignancy (HM). Material and Method: Between 2000 and 2013, 1700 adult patients underwent PNL for the treatment of kidney stones in our institution. Four of these patients had a history of HM and considered to be HM group (n=4). Ten elderly (>65 years) patients who had no history of operation, HM or any other co-morbide diseases were chosen as the control group (n=10). Surgical parameters, success rates, additional treatments and complications were evaluated. Results: Statistical analyses showed no significant differences between HM and control group according to stone area, operation time, fluoroscopy time, hospitalization time, ∆Hb, blood transfusion rates and INR values (p>0.05). Statistical analyses revealed no significant differences between HM and control groups according to the success rates (p=0.470). Statistical analyses revealed no significant difference between groups for additional treatment requirements (p=0.882). No major perioperative complication was seen in both of the groups. Discussion: The treatment of kidney stone disease by PNL in patients with hematological malignancy is feasible, safe and effective. However, close cooperation with the Hematology Department before the operation is mandatory.

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“…Furthermore, haematological malignancies may lead to antibody deficiency, leucopenia or impaired T-cell function. Previous reports demonstrate infection as the primary cause of morbidity 2,3,8. Some studies show morbidity rates of between 23 and 57%.…”

Section: Discussionmentioning

confidence: 99%

Can cardiac surgery be performed safely on patients with haematological malignancies

Güler

Şahin

Cingoz

et al. 2012

Cardiovascular Journal of Africa

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IntroductionSurgical strategy in patients with haematological malignancies must be planned and carried out with the specific aim of decreasing postoperative complications. The aim of this study was to present our experience on patients previously diagnosed with haematological malignancies who subsequently underwent cardiac surgery. We include data to assist other surgeons predict factors affecting postoperative morbidity and mortality in this group of patients.MethodsFifteen patients diagnosed with haematological malignancies who had cardiac surgery were retrospectively analysed. Eight patients had chronic lymphocytic leukaemia, six had non-Hodgkin’s lymphoma and the rest had chronic myelocytic leukaemia. Coronary artery bypass graft surgery was performed on all of them.ResultsThere were no hospital mortalities. The average follow-up period was 35 ± 11 (23–56) months. Three patients required early postoperative re-operation because of excessive bleeding. No mortalities were seen in the early postoperative period. There were five (33%) deaths during the late follow-up period. Three patients were lost due to intracranial bleeding (confirmed by autopsy) in the 16th, 23rd and 38th months after surgery. The remaining two patients had sudden death in the eighth and 55th months from non-detectable causes.ConclusionConclusion: Cardiac surgery can be performed with acceptable early postoperative outcomes in patients with haematological malignancies. Intracranial bleeding is an important factor contributing to late mortality and patient selection and risk stratification are crucial to improving surgical benefits.

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Coronary artery bypass grafting in patients with chronic lymphocytic leukemia

Cited by 18 publications

References 22 publications

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Percutaneous Nephrolithotomy for Kidney Stones in Patients with Hematological Malignancy

Can cardiac surgery be performed safely on patients with haematological malignancies

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