Luo Congcong, Zhu Jiaquan, Bao Chunrong, Ding Fangbao, Mei Ju
Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
J Cardiothorac Surg. 2019 Apr 11;14(1):76. doi: 10.1186/s13019-019-0890-2.
Primary cardiac tumors are rare and the majorities are benign. Conventional surgical treatment uses median sternotomy, while minimally invasive surgery from right anterolateral minithoracotomy has become an alternative method in recent years. In this study, we summarized the surgical outcomes of both approaches.
From January 2008 to August 2018, 50 patients with primary benign cardiac tumors underwent either conventional or minimally invasive surgery in our department. The baseline data were collected. The peri-operative data and follow up results were compared between the two groups.
There were19 men and 31 women enrolled in this study with a mean age of 55.0 ± 17.5 years. The most common site of the tumor was left atrium (n = 40, 80%), followed by right atrium (n = 8, 16.0%), right ventricle (n = 1, 2.0%) and left ventricle (n = 1, 2.0%). All patients underwent surgery uneventfully, including 33 cases (66.0%) of median sternotomy and 17 cases (34.0%) of right anterolateral minithoracotomy. No significant differences were found between the two groups in terms of cardiopulmonary bypass time, aortic cross-clamp time, postoperative intubation time, intensive care unit days and length of the hospital stay. Patients with right anterolateral minithoracotomy had less post-operative chest drainage (536 ± 159 vs 773 ± 255 ml, P < 0.01) and transfusion rate (5.9% vs 33.3%, P = 0.033) than those who had sternotomy. There was no peri-operative death, and all the patients were alive and free of recurrence at the latest follow-up.
Surgical resection of primary benign cardiac tumors is safe, effective and durable. The right anterolateral minithoracotomy provides the same postoperative recovery as standard median sternotomy, but less transfusion. It can be considered as a promising alternative approach.
原发性心脏肿瘤较为罕见，大多数为良性。传统的手术治疗采用正中胸骨切开术，而近年来经右前外侧小切口的微创手术已成为一种替代方法。在本研究中，我们总结了这两种手术方式的治疗结果。
2008年1月至2018年8月，50例原发性良性心脏肿瘤患者在我科接受了传统手术或微创手术。收集了基线数据。比较了两组患者的围手术期数据和随访结果。
本研究共纳入19例男性和31例女性，平均年龄为55.0±17.5岁。肿瘤最常见的部位是左心房（n = 40，80%），其次是右心房（n = 8，16.0%）、右心室（n = 1，2.0%）和左心室（n = 1，2.0%）。所有患者手术均顺利，其中33例（66.0%）采用正中胸骨切开术，17例（34.0%）采用右前外侧小切口手术。两组患者在体外循环时间、主动脉阻断时间、术后插管时间、重症监护病房天数和住院时间方面无显著差异。右前外侧小切口手术患者的术后胸腔引流量（536±159 vs 773±255 ml，P < 0.01）和输血率（5.9% vs 33.3%，P = 0.033）均低于正中胸骨切开术患者。围手术期无死亡病例，所有患者在最近一次随访时均存活且无复发。
原发性良性心脏肿瘤的手术切除安全、有效且持久。右前外侧小切口手术与标准正中胸骨切开术术后恢复相同，但输血较少。它可被视为一种有前景的替代方法。
