Kenawy Ayman, Abdelbar Abdelrahman, Zacharias Joseph
Department of Cardiothoracic Surgery, Lancashire Heart Centre, Blackpool Teaching Hospital, Blackpool, UK.
J Thorac Dis. 2021 Mar;13(3):1993-1999. doi: 10.21037/jtd-20-1201.
Primary cardiac tumours for which surgical resection is the main stay of treatment are rare and present both diagnostic and management challenges. The majority of patients are asymptomatic and one third of those who have symptoms present with vague constitutional symptoms which further complicates the process of early diagnosis. The current state-of-the art multi-modality imaging, routine use of intra-operative transoesophageal echocardiogram (TOE) in most cardiac centres and the tremendous advances of endoscopic adjuncts greatly enhances both the diagnosis and management of those group of patients. The surgical burden of median sternotomy and the contemporary trend towards less invasive surgery urged the necessity for adopting minimally invasive surgery in general and cardiac tumours are no exception. Despite the rarity of theses tumours, minimally invasive resection is successful in the hands of experienced minimally invasive surgeons who employ the same minimal access valve surgery platform to access the tumours in various cardiac chambers and valves with no compromise to the oncological clearance and hence achieve the benefits of minimally invasive surgery without compromising long term outcomes.
以外科手术切除为主要治疗手段的原发性心脏肿瘤较为罕见，在诊断和治疗方面均面临挑战。大多数患者无症状，有症状的患者中三分之一表现为模糊的全身症状，这进一步使早期诊断过程复杂化。当前先进的多模态成像技术、大多数心脏中心常规使用术中经食管超声心动图（TOE）以及内镜辅助技术的巨大进步，极大地提高了这类患者的诊断和治疗水平。正中胸骨切开术的手术负担以及当代向微创手术发展的趋势，促使在一般情况下采用微创手术成为必要，心脏肿瘤也不例外。尽管这些肿瘤罕见，但在经验丰富的微创外科医生手中，微创切除术是成功的，他们采用相同的微创瓣膜手术平台来处理各个心腔和瓣膜中的肿瘤，在不影响肿瘤切除范围的情况下，实现了微创手术的益处，且不影响长期治疗效果。
