TAILIEUCHUNG - Báo cáo y học: " Detrimental effect of cardiopulmonary bypass (CPB) on malignant diseas"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Detrimental effect of cardiopulmonary bypass (CPB) on malignant disease. | Darwazah and Shehata Journal of Cardiothoracic Surgery 2011 6 13 http content 6 1 13 COMMENTARY JCTS JOURNAL OF CARDIOTHORACIC SURGERY Open Access Detrimental effect of cardiopulmonary bypass CPB on malignant disease Ahmad K Darwazah Saleh Shehata Abstract Patients with coronary artery disease associated with malignancy are a difficult group of patients to treat. The ideal approach to manage them is still controversial. Both problems can be manage by either a combined or staged operation. The use of CPB during revascularization of the myocardium among patients with malignant disease may have an effect on dissimination of malignant cells. This was observed among two of our patients. We believe that the use of off-pump technique to revascularize the myocardium is a safe approach and can be performed either in combined or staged surgery to resect malignant disease. Commentary Patients with coronary artery disease associated with malignancy are a difficult group of patients to treat. The ideal approach to manage them is still controversial. Both problems can be managed by either a combined or staged operation. The real issue lies in the technique of bypass used to revascularize the myocardium. We and others proved that off-pump technique is a safe approach used to revascularize the myocardium which can be done with excision of the tumour at the same time or in a staged surgery 1 2 . The effect of CPB on malignant cell growth and dis-simination is not known. It is well documented that the use of CPB has a direct inhibitory effect on both cell mediated and humoral immunity 3 which subsequently may affect the spread of malignant cells. The use of standared CPB to revascularize the myocardium among these patients showed contradicting results. Most of the studies found that this technique is safe and efficient when used in combined surgery to treat both lung cancer and myocardial revascularization 4 5 . Others found that some of their patients

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