Simultaneous cardiac surgery with pulmonary resection

Šantavý, Petr; Szkorupa, Marek; Bohanes, T; Lonský, Vladimír

doi:10.1016/j.crvasa.2015.02.007

Cited by 9 publications

(26 citation statements)

References 15 publications

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“…As median sternotomy was often employed as a single incision to perform the cardiac and pulmonary surgery simultaneously, concern existed regarding the safety and adequacy of oncological pulmonary and lymph node resection (6,8,14,17). Through a median sternotomy, left lower lobectomy was technically believed to be the most di cult pulmonary lobectomy (9,12,16,33,42). The intraoperative view of left lower lobectomy was obscured by the heart.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 29 eligible studies were nally included in the present metaanalysis (3,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). These studies were carried out in the following geographical regions: ve in USA (8,19,20,32,35), four in China (3,11,25,26), four in Netherlands (7,13,30,33), three in Italy (14,18,29), two in Czech Republic (12,24), two in Japan (10,16), two in Turkey (9, 15), one in Australia (34), one in Belgium (6), one in C...…”

Section: Study Searches and Characteristicsmentioning

confidence: 99%

“…Treatment options include either simultaneous or staged surgical procedures (4)(5)(6)(7)(8). Without postponing the treatment of either heart or lung diseases, simultaneous surgery can solve heart and lung lesions at the same time, thus avoiding the second operation (3,(9)(10)(11)(12). But, concern exists regarding the potentially increased mortality and complication rate of simultaneous surgery and the adequacy of lung exposure during heart surgery (8,(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

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Perioperative outcomes of combined heart surgery and lung tumor resection: A systematic review and meta-analysis

Cheng

Jiang

et al. 2020

Preprint

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Objective: The coexistence of concomitant lesions of the heart and lungs needed surgical intervention is increasing. Simultaneous cardiac surgery with pulmonary resection can solve the lesions at the same time, thus avoiding the second operation. However, concern exists regarding the potentially increased mortality and complication rate of simultaneous surgery and the adequacy of lung exposure during heart surgery. Therefore, we performed a meta-analysis to evaluate the perioperative mortality and complication rate of combined heart surgery and lung tumor resection.Methods: A comprehensive literature search was performed in July 2020. PubMed, Embase and Web of Science databases were searched to collect studies reported the perioperative outcomes of combined heart surgery and lung tumor resection. Two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies. Pooled proportion and its 95% confidence intervals (95% CI) was performed by R version 3.6.1 using the meta package.Results: A total of 536 patients from 29 studies were included in this analysis. Overall, the results of this meta-analysis showed that the pooled proportion of operative mortality was 0.01 (95% CI: 0.00, 0.03) and the pooled proportion of postoperative complications was 0.40 (95% CI: 0.24, 0.57) for patients underwent combined cardiothoracic surgery. Subgroup analysis by lung pathology revealed that, for lung cancer patients, the pooled proportion of anatomical lung resection was 0.99 (95% CI: 0.95, 1.00), and the pooled proportion of systematic lymph node dissection or sampling was 1.00 (95% CI: 1.00, 1.00). Subgroup analysis by heart surgery procedures found that the pooled proportion of postoperative complications of coronary artery bypass grafting (CABG) patients using off-pump method was 0.17 (95% CI: 0.01, 0.43), while the pooled proportion of on-pump method was 0.61 (95% CI: 0.38, 0.82).Conclusion: This study presented that combined heart surgery and lung tumor resection had a low mortality rate and an acceptable complication rate. Subgroup analysis revealed most lung cancer patients underwent uncompromised anatomical resection and mediastinal lymph node sampling or dissection during combined cardiothoracic surgery, and showed off-pump CABG could potentially reduce the complication rate compared with on-pump CABG. While further researches are still needed.

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Section: Discussionmentioning

confidence: 99%

Section: Study Searches and Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perioperative outcomes of combined heart surgery and lung tumor resection: A systematic review and meta-analysis

Cheng

Jiang

et al. 2020

Preprint

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“…Simultaneous cardiac surgery and pulmonary resection for malignancy have become almost a standard treatment of patients who require heart and lung surgery. 12 – 20 In recent years, cardiac operation has not been limited to CABG. It is also seen in the heart valve replacement and aortic aneurysm operation.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous surgery in patients with both cardiac and noncardiac diseases

Yang¹,

Xiao²,

Wang³

et al. 2016

PPA

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BackgroundTo investigate the possibility and feasibility of simultaneous cardiac and noncardiac surgery.MethodsFrom August 2000 to March 2015, 64 patients suffering from cardiac and noncardiac diseases have been treated by simultaneous surgeries.ResultsTwo patients died after operations in hospital; thus, the hospital mortality rate was 3.1%. One patient with coronary heart disease, acute myocardial infarction, and a recurrence of bladder cancer accepted emergency simultaneous coronary artery bypass grafting (CABG), bladder cystectomy, and ureterostomy. He died of acute cerebral infarction complicated with multiple organ failure on the 153rd day after operation. The other patient with chronic constrictive pericarditis and right lung cancer underwent pericardial stripping and right lung lower lobectomy, which resulted in multiple organ failure, and the patient died on the tenth day postoperatively. The remaining 62 patients recovered and were discharged. The total operative morbidity was 17.2%: postoperative hemorrhage (n, % [1, 1.6%]), pulmonary infection and hypoxemia (2, 3.1%), hemorrhage of upper digestive tract (1, 1.6%), incisional infection (3, 4.7%), subphrenic abscess (1, 1.6%), and postoperative acute renal failure and hemofiltration (3, 4.7%). Of the 62 patients discharged, 61 patients were followed up. Eleven patients died with 10 months to 10 years during the follow-up. The mean survival time is 116.2±12.4 months. The cumulative survival rate is 50.8%.ConclusionSimultaneous surgeries in patients suffering from both cardiac and noncardiac benign or malignant diseases are safe and possible with satisfactory short-term and long-term survival.

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“…However, exists criticism related to the possible CPB effects on malignancy, proper extent of lung resection from the non-standard approach and higher risk of bleeding. According to Santavy et al 10 based on 10 patients, combined treatment of cardiac disease and lung cancer is a feasible and safe method with excellent results. It can be carried out with acceptable morbidity and mortality.…”

Section: Combined Heart Surgery and Lung Resectionmentioning

confidence: 99%

The cardiopulmonary bypass and cancer dissemination puzzle

Évora

Albuquerque²,

Nadai³

et al. 2018

Acta Cir. Bras.

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Early cancer diagnosis, new therapies that increased survival of patients, besides the increasingly elderly population are some factors would be associated with possible cancer dissemination in patients under cardiopulmonary bypass (CPB) cardiac surgery. Also, the benefits, and risks, regarding long-term survival, have not yet been established. Therefore, cardiac surgery morbimortality may be superior in patients with cancer disease. Also, immunologic and inflammatory changes secondary to CPB can also increase tumor recurrence. After a brief introduction and CPB immunologic the two main topic subjects included: 1) Combined heart surgery and lung resection and; 2) Possible influence of neoplasia type. After observing the relative literature scarcity, we keep the opinion that "CPB has a modest association with cancer progression" and that "CPB and cancer dissemination should be a logical but unlikely association."

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Simultaneous cardiac surgery with pulmonary resection

Cited by 9 publications

References 15 publications

Perioperative outcomes of combined heart surgery and lung tumor resection: A systematic review and meta-analysis

Perioperative outcomes of combined heart surgery and lung tumor resection: A systematic review and meta-analysis

Simultaneous surgery in patients with both cardiac and noncardiac diseases

The cardiopulmonary bypass and cancer dissemination puzzle

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