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体外膜肺氧合（ECMO）辅助纵隔肿瘤切除术和上腔静脉置换术是安全可行的。

Extracorporeal membrane oxygenation (ECMO) assisted mediastinal tumor resection and superior vena cava replacement are safe and feasible.

机构信息

Department of Thoracic Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.

Department of Vasculocardiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.

出版信息

Thorac Cancer. 2019 Sep;10(9):1846-1851. doi: 10.1111/1759-7714.13140. Epub 2019 Jul 12.

DOI:10.1111/1759-7714.13140
PMID:31297984
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6718025/
Abstract

BACKGROUND

How to maximally improve the drainage of intracranial and upper body venous and to reduce neurological complications during thoracic tumor-causedsuperior vena cava replacement are still clinical problems to be solved.

METHODS

We have innovatively used the bilateral jugular vein-left femoral vein ECMO shunting to perform mediastinal tumor resection and superior vena cava replacement in a 50-year-old woman.

RESULTS

During the operation, this technique maintained the patient's hemodynamic stability, improved the cerebral oxygen saturation and reduced the cerebral ischemia, hypoxia as well as the neurological complications.

CONCLUSION

It is indicated for patients with superior vena cava replacement who are unable to perform venous bypass (such as innominate vein to right atrial bypass) or venous shunting (such as differential pressure drainage from internal jugular vein to femoral vein).

摘要

背景

如何最大限度地提高颅内和上半身静脉的引流，并减少胸部肿瘤引起的上腔静脉置换术的神经并发症，仍然是有待解决的临床问题。

方法

我们创新性地使用双侧颈内静脉-左股静脉 ECMO 转流，为一名 50 岁女性进行了纵隔肿瘤切除和上腔静脉置换术。

结果

在手术过程中，该技术维持了患者的血流动力学稳定，提高了脑氧饱和度，减少了脑缺血、缺氧和神经并发症。

结论

该技术适用于无法进行静脉旁路（如无名静脉至右心房旁路）或静脉分流（如颈内静脉至股静脉压差引流）的上腔静脉置换术患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/6718025/b74cf0e0a1e5/TCA-10-1846-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/6718025/fec6eafb0595/TCA-10-1846-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/6718025/b74cf0e0a1e5/TCA-10-1846-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/6718025/fec6eafb0595/TCA-10-1846-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/6718025/b74cf0e0a1e5/TCA-10-1846-g002.jpg

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J Thorac Dis. 2018 Jan;10(1):363-370. doi: 10.21037/jtd.2017.12.130.
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Reconstruction of mediastinal vessels for invasive thymoma: a retrospective analysis of 25 cases.侵袭性胸腺瘤纵隔血管重建：25例回顾性分析
J Thorac Dis. 2017 Mar;9(3):725-733. doi: 10.21037/jtd.2017.03.03.
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Radical surgical resection of advanced thymoma and thymic carcinoma infiltrating the heart or great vessels with cardiopulmonary bypass support.
体外循环不会导致巨大难治性胸壁肿瘤术后远处转移：一项长期随访的回顾性研究。
Thorac Cancer. 2021 Nov;12(22):2990-2995. doi: 10.1111/1759-7714.14162. Epub 2021 Sep 16.
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Surgical feasibility and long-term outcome of superior vena cava replacement for advanced thymoma in patients undergoing preoperative chemotherapy or chemoradiotherapy.术前化疗或放化疗后进展性胸腺瘤患者行上腔静脉置换术的手术可行性及长期疗效。
Thorac Cancer. 2021 Apr;12(7):1074-1083. doi: 10.1111/1759-7714.13872. Epub 2021 Feb 10.
在体外循环支持下对侵犯心脏或大血管的晚期胸腺瘤和胸腺癌进行根治性手术切除。
J Cardiothorac Surg. 2015 Oct 29;10:137. doi: 10.1186/s13019-015-0346-2.
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