不血管重建的肿瘤合并颈动脉切除术  

Resection of Tumor and Carotid Artery without Artery Anastomosis

作　　者：张艳[1] 高明[1] 李树玲[1] 

机构地区：[1]天津市肿瘤防治重点实验室天津医科大学附属肿瘤医院头颈科

出　　处：《中国肿瘤临床》2009年第4期227-229,共3页Chinese Journal of Clinical Oncology

摘　　要：目的：总结天津医科大学附属肿瘤医院头颈科1979年～2002年间对颈部肿瘤固定于颈动脉的患者施行不血管重建的颈动脉切除术31例的经验。方法：对颈部肿瘤固定于颈动脉的患者自1979年施行首例不血管重建的颈动脉切除术成功以来，至2002年4月共行此术31例，其中男17例，女14例，年龄14～58岁，以21～40岁最多，共21例．占67．8％。31例中包括颈动脉体瘤23例（恶性8例），迷走神经体瘤2例（恶性l例），颈动脉瘤4例，颈部转移癌累及颈动脉2例。31例中，曾接受肿瘤不全切除术22例。术前行颈动脉压迫锻炼，准确检测脑代偿供血合格后，行肿瘤合并颈动脉切除术。结果：31例患者无手术死亡，无术后脑血管并发症。死于肿瘤未控制3例：其中l例恶性颈动脉体瘤术后1年因远处转移死亡，2例转移癌术后2～5年死于癌复发及远处转移。28例术后6～29年均健在，5年生存率为90．3％。健在28例病例中未出现脑供血不全表现，预后良好。结论：不血管重建的肿瘤合并颈动脉切除术是安全可行的。另外，较合并血管重建术具以下优点：①因不考虑血管重建，肿瘤切除应更较彻底；②术后甚少产生血栓、感染或致命性血管破裂出血等并发症；③如需术后放疗，可无顾虑；④术式更加简化。Objective： To summarize the treatment experience for 31 patients who underwent tumor and carotid artery resection without anastomosis in our hospital between 1979 and 2002. Methods： There were 17 males and 14 females ranging in age from 14 to 58 years. There were 23 cases of carotid body tumor （includ- ing 8 malignant cases）, 2 cases of vagus nerve body tumor （including 1 malignant case）, 4 cases of carotid a- neurysm, and 2 cases of metastatic tumor in the neck involving the carotid artery. There were 22 cases who had previously received incomplete tumor resection. We performed carotid artery oppression on all of the 31 patients to evaluate the blood supply. Results： No intraoperative death or CNS complications were observed. Of the 3 patients who died of failure of disease control, one died of distant metastasis at 1 year after surgery, and the other two cases died of cancer relapse or distant metastasis at 2-5 years after surgery. The survival period of the other 28 cases ranged from 6 to 29 months. The 5-year survival rate of the 31 cases was 90.3%. Conclusion： Tumor and carotid artery resection without artery anastomosis is a safe procedure for patients with tumors in the neck, and it has a lower rate of postoperative complications including thrombus, infection, and vessel rupture.

关 键 词：肿瘤 颈动脉切除术 血管重建 

分 类 号：R739.91[医药卫生—肿瘤]