自体心包代血管治疗局部晚期恶性胸腺瘤6例  

Autogenous pericardial angioplasty for thymic malignancies:techniques and short-term survival analysis

作　　者：高会江[1] 石国栋 潘茂杰 于文泉 汤嘉宇 魏煜程 Gao Huijiang;Shi Guodong;Pan Maojie;Yu Wenquan;Tang Jiayu;Wei Yucheng(Department of Thoracic Surgery,Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Thoracic Surgery,Linyi People's Hospital,Linyi 276000,China)

机构地区：[1]青岛大学附属医院胸外科,266000 [2]临沂市人民医院胸外科,276000

出　　处：《中华胸心血管外科杂志》2020年第11期652-655,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨自体心包移植纵隔大血管重建治疗局部晚期恶性胸腺瘤技术的安全性与近期疗效。方法回顾性分析2017年4月至2018年10月在青岛大学附属医院胸外科同一诊疗组,接受自体心包移植左头臂静脉旁路重建联合上腔静脉修补的6例局部晚期恶性胸腺瘤患者临床资料,分析其手术时间、术中出血量、胸腔引流时间、术后住院时间、术后并发症、移植物血管通畅情况以及近期预后等指标。结果全组手术(192.3±32.5)min,术中出血(105.0±27.5)ml,胸腔引流(4.5±1.5)天,术后住院(5.3±2.5)天。患者术后生活质量满意,血管造影显示1例术后10个月左头臂静脉旁路重建血管闭塞,其他患者重建血管通畅。术后平均随访34.3个月,1例于术后23个月出现胸壁转移,接受局部放射治疗后病情稳定,余5例未见局部复发及远处转移。结论应用自体心包进行纵隔大血管重建治疗局部晚期恶性胸腺瘤安全有效,其临床应用前景值得期待。Objective To evaluate the techniques and short-term outcomes of pericardial autologous angioplasty for the reconstruction of mediastinal large vessels in the treatment of locally advanced malignant thymoma.Methods We retrospectively analyzed the clinical data of 6 patients with locally advanced malignant thymoma who received autologous pericardial transplantation for mediastinal great vascular reconstruction in the same treatment group of Department of Thoracic Surgery,the Affiliated Hospital of Qingdao University from April 2017 to October 2018.Results The operative time of malignant thymoma patients receiving autologous pericardial vascular reconstruction was(192.3±32.5)min,intraoperative blood loss was(105.0±27.5)ml,thoracic drainage time was(4.5±1.5)days,and postoperative hospital stay was(5.3±2.5)days.The postoperative quality of life of the patients was satisfactory.Angiography showed that the reconstructed vessels of the left inus vein were occluded in 1 patient 10 months after the operation,and the reconstructed vessels were unobstructed in the other patients.The average follow-up time of the patients was 34.3 months after surgery.One patient developed chest wall metastasis 23 months after surgery,and his condition was stable after receiving local radiotherapy.The other 5 patients did not occur local recurrence or distant metastasis.Conclusion The application of autologous pericardium for the reconstruction of mediastinal great vessels in the treatment of malignant thymoma is a safe and effective method,and its clinical application prospect is worth expecting.

关 键 词：胸腺瘤 胸外科手术 自体心包移植 血管重建 预后 

分 类 号：R736.3[医药卫生—肿瘤]