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作 者:张杨杨[1] 徐骁晗[1] 邵永丰[1] 仓正强 魏磊[1] 王晓伟[1]
机构地区:[1]南京医科大学第一附属医院胸心外科,南京210029 [2]南京医科大学第一临床医学院,南京211166
出 处:《外科研究与新技术》2014年第4期236-238,290,共4页Surgical Research and New Technique
摘 要:目的:探讨非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCABG)同期胸部肿瘤切除的安全性、可行性及疗效。方法19例患者冠心病合并胸部肿瘤,其中肺癌7例,食道癌5例,贲门癌4例,前纵膈肿瘤3例。同期OPCABG和胸部肿瘤切除术。结果患者手术顺利,无严重并发症,无手术死亡。18例为单一切口完成OPCABG和肿瘤切除术。手术时间(364.58±78.45)min,术中失血(615.79±371.58)ml,术后机械通气时间(930.00±225.35)min,ICU停留时间(2078±138947)min,术后住院时间(16.22±4.81)d。随访0.5~90个月,1例OPCABG同期肺癌切除患者术后8个月死于肿瘤转移,其余患者随访期间生存良好,无明显心肌缺血症状。结论 OPCABG同期胸部肿瘤切除术优于传统分期手术,具有安全性、可行性和手术创伤小等特点。Objective To explore the safty,feasibility,and efficacy of the surgical management for simultaneous off-pump coronary artery bypass grafting(OPCABG)and thoracic tumorectomy. Methods 19 patients underwent combined OPCABG and thoracic tumor resection(7 lung carcinoma,5 esophageal carcinoma,4 cardiac carcinoma,and 3 tumor of anterior mediastinum),OPCABG and tumorectomy were performed simultaneously. Results There was neither hospital mortality nor serious postoperative complications. Procedures were performed through a single incision in 18 cases. Operation time was(364.58 ± 78.45)min and the blood loss was(615.79 ± 371.58)ml,the respiratory auxiliary time was(930.00 ± 225.35)min,ICU stay was(2 078 ± 138 947)min,postoperative hospital stay was(16.22 ± 4.81) days. Follow up data were available on all patients,one patient with lung carcinoma died 8 months as metastatic carcinoma,the rest patients were disease free and survived from 0.5 to 90 months. Conclusion OPCABG and thoracic tumorectomy can be performed safely at the same time with better results than traditional two-staged approach.
关 键 词:非体外循环冠状动脉旁路移植术 胸部肿瘤 同期手术
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