肿瘤切除联合同期心脏手术18例临床分析  

Simultaneous tumor resection and cardiac operation

作　　者：宋波[1] 肖锋[1] 李岩[1] 张明礼[1] 

机构地区：[1]北京大学第一医院心脏外科,100034

出　　处：《中国肿瘤临床与康复》2007年第6期509-511,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的总结肿瘤切除联合同期心脏手术的经验。方法从2000年至2007年,我科共实施肿瘤切除联合同期心脏手术18例,其中根治性肾切除7例,肺癌根治4例,肺楔形切除3例,食管贲门癌根治2例,子宫及卵巢切除2例。同期心脏瓣膜置换1例,冠脉旁路移植(CABG)16例。体外循环3例,非体外循环15例。结果全组患者无院内死亡,1例术后发生膈下脓肿经引流痊愈。随访6～80个月,术后远期4例死亡,1例死于心肌梗死,3例死于癌扩散。本组术后1,5年生存率分别为86.6%和70.9%。结论肿瘤切除联合同期心脏手术安全可行,远期效果可能与肿瘤自身生物学行为相关。Objective To summarize the experience of simultaneous tumor resection and cardiac operations. Methods Clinical records of 18 patients were reviewed who underwent simultaneous tumor resection and cardiac operations between 2000 and 2007 in this department. Radical renal resection was performed in 7 patients, lung resection for carcinoma and hamartoma in 7 patients, esophagus resection for carcinoma in 2 patients, hysterectomy and ovariotomy for malignant tumor in 2 patients. Simultaneous cardiac operations preceded tumor resection. Coronary artery bypass was performed in 16 patients and mitral valve replacement and tricuspid valve annuloplasty in 1 patient. Fifteen patients underwent off-pump operations and 3 patients underwent on-pump ones. Results There was no hospital mortality in this group of patients. Abscess under diaphragm occurred in 1 patient who underwent esophagus resection and cured by surgical drainage. Follow-up was obtained in all 18 patients（mean follow-up period was 36 months;6 to 80 months）. There were four late deaths, one myocardial infarction and three metastatic disease. Overall late survival rates were 86.6% and 70.9% at 1 and 5 years, respectively. Conclusions Simultaneous tumor resection and cardiac operation is a safe and feasible method for patients diagnosed to have concomitant tumor and cardiac disease. The long-term survival may be related with tumor itself.

关 键 词：肿瘤 冠脉旁路移植 非体外循环 

分 类 号：R730.5[医药卫生—肿瘤] R654.2[医药卫生—临床医学]