上腔静脉置换治疗晚期胸腔恶性肿瘤42例  

The vessel resection and reconstruction in managing malignant superior vena cava sydrom

作　　者：张伟[1] 杨康[1] 廖克龙[1] 熊刚[1] 王海东[1] 谭文峰[1] 李军[1] 

机构地区：[1]第三军医大学西南医院胸心外科

出　　处：《重庆医学》2010年第16期2179-2180,共2页Chongqing medicine

摘　　要：目的探讨和总结上腔静脉置换治疗晚期胸腔恶性肿瘤的临床经验,并评价其疗效。方法 2002年1月至2009年10月手术治疗癌性上腔静脉综合征42例,其中局部晚期肺癌18例、侵袭性胸腺瘤12例、精原细胞瘤6例、非霍奇金淋巴瘤4例,胸腺瘤2例。术中行原发肿瘤和受累上腔静脉全部或部分切除并重建上腔静脉,其中采用人工血管置换40例,人工血管旁路2例。结果全组无手术死亡及术后早期死亡。平均随访24个月,无阻塞症状复发,患者1、2、3年生存率分别为85.7%、66.7%、42.8%。结论上腔静脉切除重建能安全有效地解除梗阻症状,明显提高和延长患者的生活质量及生存时间,但必须严格把握其手术适应证。Objective To evaluate and summarize the clinical experience of the vessel resection and reconstruction in surgical management of malignant superior vena cava syndrome（SVCS）.Methods From January 2002 to January 2009,42 patients with malignancy invading the superior vena cava（SVC）underwent surgical intervention.Among them locally advanced lung cancer was in 18 cases,invasive thymoma in 12,seminoma in 6 and non-Hodgkin lymphoma in 8.The primary tumor was totally or partially resected in all patients.Replacement and bypass of the SVC with Gore-Tex vascular prosthesis was performed respectively in 40 and 2 patients.Results All of the cases had no intraoperative and early postoperative death.Patients were followed up for 24 months and superiorvena cava obstruction symptom did not be observed.The overall survival rates of 1,2 and 3 years were 85.7%,66.7% and 42.8%,respectively.Conclusion The SVC system resection and reconstruction is a safe and effective therapy and can significantly improve the quality of life and increase the survival time for properly selected patients.

关 键 词：上腔静脉综合征 恶性肿瘤 血管重建 

分 类 号：R734[医药卫生—肿瘤] R730.56[医药卫生—临床医学]