微创技术在心脏肿瘤外科治疗中的临床应用  

The clinical application of minimally invasive technique in surgical treatment of cardiac tumors

作　　者：宋凯[1] 沈金强[1] 魏来[1] 夏利民[1] 丁文军[1] 孙勇新[1] 赖颢[1] 王春生[1] 

机构地区：[1]上海市心血管病研究所复旦大学附属中山医院心外科,上海200032

出　　处：《中国胸心血管外科临床杂志》2017年第8期626-629,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的介绍我院采用微创技术在心脏肿瘤外科治疗中应用的临床经验。方法 2011年1月至2014年9月,我院采用右胸前外侧切口为50例患者行微创心脏肿瘤切除手术,其中男18例、女32例,年龄47(32~65)岁。肿瘤位于左心房44例,右心房6例。结果术后无院内死亡,无延长胸部切口、再次开胸止血、脑血管意外、肾功能衰竭等严重并发症,全组平均手术时间、心肺转流时间、主动脉阻断时间分别为(148±45)min、(56±23)min、(26±16)min。术后平均机械通气时间为(5±3)h,平均住ICU时间和住院时间分别为(9±6)h和(5±3)d,术后随访1~44个月,随访率100.0%,1例右心房未分化肉瘤患者术后2个月发现右心房肿瘤复发,其余患者随访超声心动图未见肿瘤复发,恢复情况好。结论右胸前外侧切口经由房间沟或右心房-房间隔切口可同时充分暴露左、右心房内肿瘤,并可同期行二尖瓣、三尖瓣手术,手术安全有效,效果良好,美容效果佳,可选择性应用于心脏良性肿瘤切除手术。Objective To share clinical experience of minimally invasive technique in surgical treatment of cardiac tumors. Methods Clinical data of 50 patients with cardiac tumors who underwent surgical teatment in Zhongshan Hospital of Fudan University from January 2011 to September 2014 were analyzed retrospectively. There were 18 males and 32 females aged from 32 to 65 years （mean age 47 years）. Cardiac tumors were located in the left atrium in 44 （88%） patients and right atrium in 6 （12%） patients. Results There was no in-hospital death. All patients recovered well without any complications. Mean total operating, cardiopulmonary bypass and aortic cross-clamp time was 148±45 min, 56±23 min, 26±16 min, respectively. The average time to extubation was 5±3 hours and the median length of stay in the intensive care unit （ICU） and in the hospital was 9±6 hours and 5±3 days, respectively. All patients were followed up for 1 to 44 months without tumor recurrence except one. Conclusion Minimally invasive technique in surgical treatment of cardiac tumors via right anterolateral thoracotomy is a safe and feasible method with good cosmetic results and rapid postoperative recovery, and is worthy of clinical selective application for treatment of benign cardiac tumor.

关 键 词：微创 心脏肿瘤 手术 

分 类 号：R654.2[医药卫生—外科学]