Hosoba Soh, Hanaoka Jun, Suzuki Tomoaki, Takashima Noriyuki, Kambara Atsushi, Matsubayashi Keiji, Asai Tohru
Division of Cardiovascular and Thoracic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
Ann Thorac Cardiovasc Surg. 2012;18(1):8-11. doi: 10.5761/atcs.oa.11.01717. Epub 2011 Sep 15.
We report our experience of cardiac surgery with concomitant pulmonary resection, based on analysis of the results.
Eleven patients (1 woman, 10 men) underwent cardiac surgery simultaneously with pulmonary resection; ten of them through median sternotomy. The cancer pathology consisted of non-small cell carcinoma (n = 10), and benign teratoma (n = 1). All lung lesions were removed using a wedge resection. Cardiac procedures consisted of off-pump coronary artery bypass grafting (n = 4), aortic valve replacement (n = 3), mitral valve plasty (n = 2), total arch replacement (n = 1), and descending aorta replacement (n = 1). Lung wedge resections were performed after induction with protamine sulfate.
The mean follow-up period was 19 ± 11 months (2-34). There was no operative mortality and no major cardiac complications. Three patients underwent a subsequent lobectomy through lateral thoracotomy. There were two postoperative deaths: one was from an unknown cause, 8 months postoperatively and another was from a lung cancer recurrence, 9 months after surgery. There were two local recurrences, 9 months and 14 months, postoperatively. The mean cancer-free period was 17 ± 10 (2-32) months.
Rates of operative mortality and morbidity following cardiac surgery with concomitant pulmonary resection were favorable, and early to midterm results were acceptable.
基于结果分析，我们报告了同期进行心脏手术和肺切除术的经验。
11例患者（1例女性，10例男性）同期接受心脏手术和肺切除术；其中10例通过正中胸骨切开术进行。癌症病理类型包括非小细胞癌（n = 10）和良性畸胎瘤（n = 1）。所有肺部病变均采用楔形切除术切除。心脏手术包括非体外循环冠状动脉搭桥术（n = 4）、主动脉瓣置换术（n = 3）、二尖瓣成形术（n = 2）、全弓置换术（n = 1）和降主动脉置换术（n = 1）。肺楔形切除术在注射硫酸鱼精蛋白后进行。
平均随访期为19±11个月（2 - 34个月）。无手术死亡病例，也无严重心脏并发症。3例患者随后通过侧胸壁切开术进行了肺叶切除术。有2例术后死亡：1例原因不明，术后8个月死亡；另1例死于肺癌复发，术后9个月死亡。术后有2例局部复发，分别在术后9个月和14个月。平均无癌生存期为17±10（2 - 32）个月。
同期进行心脏手术和肺切除术的手术死亡率和发病率较低，早期至中期结果可接受。
