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[心脏肿瘤手术治疗后的早期结果]

[Early results following surgical treatment of heart tumors].

作者信息

Bauer E P, von Segesser L K, Carrel T, Laske A, Turina M I

机构信息

Klinik für Herzgefässchirurgie, Universitätsspital Zürich.

出版信息

Schweiz Med Wochenschr. 1991 Feb 23;121(8):255-8.

PMID:2011720
Abstract

Between December 1968 and March 1990 a total of 51 patients (24 male, 27 female) with a mean age of 49 years (7 months to 76 years) underwent surgery for primary or secondary cardiac tumor. In 46/51 cases (90%) the tumor was benign and in 5/51 (10%) malignant; 41/51 (80%) were myxomas. In 40 patients complete resection of myxoma was possible, whereas in one patient only biopsy was performed. In 6 patients an additional procedure was necessary (CABG 4 times, double valve replacement once, mitral valve reconstruction once). In 17/41 patients (41%) rhythm disturbances were observed postoperatively. No patient died after operation. In one patient surgery of a recurrent myxoma was necessary 18 months after primary operation. In 5/51 patients (10%) surgery of benign non-myxomatous tumor was performed (lipoma twice, cavernous hemangioma once, fibroma once fibrous leiomyoma once). Radical excision of tumor was not possible in 2 cases; both died soon after operation. Surgery of malignant heart tumors was performed in 5/51 patients (10%) (synovialoma once, lymphoma twice, metastasis twice). In 3 patients tumor excision was radical; there was nevertheless recurrence in all patients despite adjuvant therapy. Only 1 patient is still alive 6 months after surgery. Prognosis after surgery for heart tumors is dependent on histology and resectability. Mortality after resection of myxoma is very low, but postoperative rhythm disturbances are frequent. Survival after excision of benign non-myxomatous tumors is dependent on resectability. Malignant cardiac tumors have a very bad prognosis despite chemotherapy and radiotherapy.

摘要

1968年12月至1990年3月期间,共有51例患者(男性24例,女性27例)接受了原发性或继发性心脏肿瘤手术,平均年龄49岁(7个月至76岁)。51例中有46例(90%)肿瘤为良性,5例(10%)为恶性;51例中有41例(80%)是黏液瘤。40例患者的黏液瘤得以完整切除,而1例患者仅进行了活检。6例患者需要进行额外手术(冠状动脉旁路移植术4次,双瓣膜置换术1次,二尖瓣重建术1次)。41例患者中有17例(41%)术后出现心律失常。术后无患者死亡。1例患者在初次手术后18个月需要再次手术切除复发性黏液瘤。51例患者中有5例(10%)进行了良性非黏液瘤性肿瘤手术(脂肪瘤2次,海绵状血管瘤1次,纤维瘤1次,纤维平滑肌瘤1次)。2例患者无法进行肿瘤根治性切除;二者均在术后不久死亡。51例患者中有5例(10%)进行了恶性心脏肿瘤手术(滑膜瘤1次,淋巴瘤2次,转移瘤2次)。3例患者进行了肿瘤根治性切除;尽管进行了辅助治疗,但所有患者均复发。仅1例患者术后6个月仍存活。心脏肿瘤手术后的预后取决于组织学类型和可切除性。黏液瘤切除术后死亡率很低,但术后心律失常很常见。良性非黏液瘤性肿瘤切除术后的生存率取决于可切除性。尽管进行了化疗和放疗,恶性心脏肿瘤的预后仍然很差。

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