From the Guidelines
Tube surgery with a pericardium patch plus Mitomycin-C (MMC) is not a recommended treatment for patients with impaired renal function, as the provided evidence does not support its use in this context. Instead, the management of patients with impaired renal function and pericardial diseases should focus on established treatments, such as pericardiectomy, which is indicated for patients with chronic constrictive pericarditis who have persistent and prominent symptoms, as stated in the 2015 ESC guidelines 1. The decision to perform surgery should be made cautiously, considering the patient's overall condition, including renal function, and the potential risks and benefits of the procedure. For example, patients with significant renal dysfunction may be at higher risk for complications, and alternative approaches, such as medical management or pericardiocentesis, may be considered, as suggested by the guidelines 1. In addition, the use of Mitomycin-C (MMC) is not mentioned in the context of pericardial diseases in the provided evidence, and its application should be based on established indications and guidelines. Therefore, the treatment of patients with impaired renal function and pericardial diseases should be individualized and based on the best available evidence, with a focus on established treatments and careful consideration of the potential risks and benefits. Some key points to consider in the management of these patients include:
- The importance of careful patient selection for surgery, taking into account factors such as renal function and overall condition 1
- The need for close monitoring of renal function and adjustment of medication regimens to avoid nephrotoxic agents 1
- The potential benefits and risks of established treatments, such as pericardiectomy, and the importance of individualizing treatment decisions based on the best available evidence 1.
From the Research
Indications for Tube Surgery with Pericardium Patch + MMC
- The provided studies do not directly address the indications for tube surgery with a pericardium patch plus Mitomycin-C (MMC) in a patient with impaired renal function (glycine patient) 2, 3, 4, 5, 6.
- However, the studies discuss the treatment of pericardial diseases, including pericarditis, and the use of colchicine as a first-line treatment option for acute and recurrent pericarditis 3, 5.
- Surgical management of pericardial diseases is also discussed, including the evolution of indications for pericardiectomy and new applications in inflammatory or relapsing pericarditis 4, 6.
- The use of MMC is not mentioned in the provided studies, and therefore, its indications and effectiveness in tube surgery with a pericardium patch cannot be determined based on the available evidence.
Pericardial Diseases and Surgical Management
- Pericardial diseases, such as pericarditis and constrictive pericarditis, may require surgical management, including drainage or removal of the pericardium 4, 6.
- The surgical approach to the pericardium has relied largely on institutional experience, and there exist no widely accepted guidelines for surgical management 4.
- The use of a pericardium patch in surgical procedures is not specifically addressed in the provided studies, and its indications and effectiveness cannot be determined based on the available evidence.
Limitations of Available Evidence
- The provided studies do not address the specific question of indications for tube surgery with a pericardium patch plus MMC in a patient with impaired renal function (glycine patient) 2, 3, 4, 5, 6.
- The available evidence is limited to the treatment of pericardial diseases, including pericarditis, and the use of colchicine as a first-line treatment option 3, 5.
- Further research is needed to determine the indications and effectiveness of tube surgery with a pericardium patch plus MMC in patients with impaired renal function.