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Journal of Cardiothoracic Surgery

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01-12-2021 | Lung Cancer | Research article

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

Authors: Shizhao Cheng, Yiyao Jiang, Xin Li, Xike Lu, Xun Zhang, Daqiang Sun

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Objective

The prevalence of patients with concomitant heart and lung lesions requiring surgical intervention is increasing. Simultaneous cardiac surgery and pulmonary resection avoids the need for a second operation. However, there are concerns regarding the potentially increased mortality and complication rates 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 rates of combined heart surgery and lung tumor resection.

Methods

A comprehensive literature search was performed in July 2020. The PubMed, Embase, and Web of Science databases were searched to identify studies that reported the perioperative outcomes of combined heart surgery and lung tumor resection. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias of included studies. Pooled proportions and 95% confidence intervals (95% CI) were calculated by R version 3.6.1 using the meta package.

Results

A total of 536 patients from 29 studies were included. Overall, 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 who underwent combined cardiothoracic surgery. Subgroup analysis by lung pathology revealed that, for patients with lung cancer, 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 procedure found that the pooled proportion of postoperative complications of patients who underwent coronary artery bypass grafting (CABG) patients using the off-pump method was 0.17 (95% CI: 0.01, 0.43), while the pooled proportion of complications after CABG using the on-pump method was 0.61 (95% CI: 0.38, 0.82).

Conclusion

Combined heart surgery and lung tumor resection had a low mortality rate and an acceptable complication rate. Subgroup analyses revealed that most patients with lung cancer underwent uncompromised anatomical resection and mediastinal lymph node sampling or dissection during combined cardiothoracic surgery, and showed off-pump CABG may reduce the complication rate compared with on-pump CABG. Further researches are still needed to verify these findings.

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Title: Perioperative outcomes of combined heart surgery and lung tumor resection: a systematic review and meta-analysis
Authors: Shizhao Cheng
Yiyao Jiang
Xin Li
Xike Lu
Xun Zhang
Daqiang Sun
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Lung Cancer
Heart Surgery
Lung Cancer
Heart Surgery
CABG
Lung Cancer
CABG
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01607-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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