通过延长胸骨切开术同时进行肾切除术和冠状动脉搭桥术。
Simultaneous nephrectomy and coronary artery bypass grafting through extended sternotomy.
作者信息
Budrikis Algimantas, Jievaltas Mindaugas, Al Assaad Sami, Kinduris Sarunas
机构信息
Department of Cardiothoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Eiveniu str, 2, 50009, Kaunas, Lithuania.
出版信息
J Cardiothorac Surg. 2012 Aug 30;7:79. doi: 10.1186/1749-8090-7-79.
BACKGROUND
The advances in surgical techniques, resuscitation and anesthesiology support over the last years have allowed simultaneous thoracic and abdominal operations to be made for cancer and concomitant severe heart vessel disease relieving the patient from several diseases simultaneously and achieving long lasting remission or cure.
CLINICAL CASE
A simultaneous nephrectomy and coronary artery bypass grafting procedure through extended sternotomy is reported. A 63-year-old man with severe coronary artery disease was found to have renal carcinoma.
DIAGNOSIS
Postoperative pathological investigation of the tumor revealed the presence of renal cell carcinoma pT3a N0 M0, G2. Coronarography revealed advanced three-vessel coronary artery disease.
TREATMENT
We successfully performed a simultaneous curative surgery for renal carcinoma and coronary artery bypass graft surgery under cardiopulmonary bypass using a novel technique of extended sternotomy. Simultaneous surgery thus appears to be a beneficial and safe approach for the treatment of coronary artery disease and resectable renal cancer in carefully selected patients.
背景
过去几年外科技术、复苏及麻醉学支持方面的进展，使得针对癌症及并发的严重心血管疾病能够同时进行胸腹部手术，从而使患者同时摆脱多种疾病，并实现长期缓解或治愈。
临床病例
报告了一例通过扩大胸骨切开术同时进行肾切除术和冠状动脉搭桥手术的病例。一名患有严重冠状动脉疾病的63岁男性被发现患有肾癌。
诊断
肿瘤的术后病理检查显示存在肾细胞癌，pT3a N0 M0，G2级。冠状动脉造影显示存在严重的三支血管冠状动脉疾病。
治疗
我们采用一种新型的扩大胸骨切开术技术，在体外循环下成功地同时进行了肾癌根治性手术和冠状动脉搭桥手术。因此，对于经过精心挑选的患者，同时手术似乎是治疗冠状动脉疾病和可切除肾癌的一种有益且安全的方法。
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