左无名静脉-右心耳旁路移植术治疗复杂前上纵隔肿瘤效果分析  

Aualysis of left innominate vein-right atrial appendage bypass for complex anterior mediastinal tumor

作　　者：鲍峰[1,2] 宫为一 蒋家好[2] 丁建勇 BAO Feng;GONG Wei-yi;JIANG Jia-hao;DING Jian-yong(Department of Thoracic Surgery,Anhui Provincial Armed Police Corps Hospital,Hefei230000,Anhui,China;Department of Thoracic Surgery,Zhongshan Hospital,Fudan University,Shanghai200032,China)

机构地区：[1]武警安徽省总队医院胸外科,合肥230000 [2]复旦大学附属中山医院胸外科,上海200032

出　　处：《中国临床医学》2019年第4期581-585,共5页Chinese Journal of Clinical Medicine

摘　　要：目的:总结复杂前上纵隔肿瘤的手术治疗经验,评价左无名静脉-右心耳旁路移植术的疗效。方法:回顾性分析8例骑跨于上腔静脉及左右无名静脉的前上纵隔肿瘤患者的资料。其中B2与B3混合型胸腺瘤1例,B2型胸腺瘤2例,纵隔神经内分泌癌(类癌)2例,胸腺鳞癌3例。术中均行人工血管左无名静脉-右心耳旁路移植术,并完整切除原发肿瘤和受累及部分上腔静脉、左右无名静脉。结果:8例患者均顺利出院,无围手术期严重并发症,1例术后9个月骨转移死亡。结论:对于治疗无远处转移的侵犯上腔静脉和左右无名静脉并引起上腔静脉综合征的纵隔肿瘤,左无名静脉-右心耳旁路人工血管移植术可以提高切除率,缓解临床症状,进而延长此类患者的生存期。Objective:To summarize the experience of surgical treatment of complex anterior mediastinum tumor and evaluate the efficacy of left innominate vein-right atrial appendage bypass.Methods:The clinical data of 8 patients with anterior superior mediastinum tumor straddling the superior vena cava and left and right anterior veins were retrospectively analyzed.One patient had B2 and B3 mixed thymoma,2 patients had B2 thymoma,2 patients had mediastinal neuroendocrine cancer(carcinoid),and 3 patients had thymic squamous cell carcinoma.During the operation,left innominate vein-right atrial appendage bypass with artificial blood vessels were performed,and the primary tumor and part of the superior vena cava involved were completely resected.Results:All 8 patients were discharged smoothly without serious complications during perioperative period,one patient died of bone metastasis 9 months after operation.Conclusions:Left innominate vein-right atrial appendage bypass can improve resection rate,relieve clinical symptoms,and prolong survival of patients with mediastinal tumor that invade superior vena cava and left and right innominate veins without distant metastasis and causing superior vena cava syndrome.

关 键 词：旁路移植 纵隔肿瘤 无名静脉 

分 类 号：R655.6[医药卫生—外科学]