心脏黏液瘤的手术切除——30年单机构经验
Surgical resection of cardiac myxoma-a 30-year single institutional experience.
作者信息
Lee Kyo Seon, Kim Gwan Sic, Jung Yochun, Jeong In Seok, Na Kook Joo, Oh Bong Suk, Ahn Byung Hee, Oh Sang Gi
机构信息
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University School of Medicine, 42, Jebong-ro, Dong-gu, Gwangju, 15772, South Korea.
出版信息
J Cardiothorac Surg. 2017 Mar 27;12(1):18. doi: 10.1186/s13019-017-0583-7.
BACKGROUND
Primary cardiac tumors are rare and myxoma constitutes the majority. The present study summarizes our 30-year clinical outcomes of surgical myxoma resection.
METHODS
Between January 1986 and December 2015, 93 patients (30 men, 63 women; mean age, 54.7 ± 16.6 years) underwent surgical myxoma resection. The most common origin site was the left atrium. Surgery was performed via a biatrial approach in 74.2%, atrial septotomy through right atriotomy in 17.2%, and left atriotomy only in 8.6%. Mean myxoma size based on longest length was 4.73 ± 1.92 cm (range, 1.2-11.0 cm).
RESULTS
The mean follow-up duration was 9.9 ± 7.8 years (range, 0-29 years). In-hospital mortality was 3.2%. The most common postoperative complication was atrial fibrillation (4.3%). The 5-, 10-, and 30-year survival rates were 92.9%, 87.2%, and 75.5%, respectively. Recurrence occurred in two patients (2.1%), which were detected at 20 and 79 months after the first surgery, respectively.
CONCLUSIONS
Long-term survival after myxoma resection was excellent and recurrence was rare. Based on our experience, surgical method did not affect the outcome.
背景
原发性心脏肿瘤较为罕见，其中黏液瘤占大多数。本研究总结了我们30年来手术切除黏液瘤的临床结果。
方法
1986年1月至2015年12月期间，93例患者（30例男性，63例女性；平均年龄54.7±16.6岁）接受了黏液瘤切除术。最常见的起源部位是左心房。74.2%的患者通过双心房入路进行手术，17.2%的患者通过右心房切开术进行房间隔切开术，仅8.6%的患者进行左心房切开术。基于最长长度的黏液瘤平均大小为4.73±1.92厘米（范围1.2 - 11.0厘米）。
结果
平均随访时间为9.9±7.8年（范围0 - 29年）。住院死亡率为3.2%。最常见的术后并发症是心房颤动（4.3%）。5年、10年和30年生存率分别为92.9%、87.2%和75.5%。两名患者（2.1%）出现复发，分别在首次手术后20个月和79个月被发现。
结论
黏液瘤切除术后长期生存率良好，复发罕见。根据我们的经验，手术方法不影响治疗结果。
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