Division of Cardiovascular Surgery, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang Dist, 710, Tainan City, Taiwan.
Division of Cardiovascular Surgery, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, No.699, Section 8, Taiwan Boulevard, Wuqi District, Taichung City, 43503, Taiwan.
J Cardiothorac Surg. 2022 Oct 6;17(1):258. doi: 10.1186/s13019-022-01978-5.
Cardiac myxoma is the most common benign cardiac tumor. Its tremendous size and fragile character severely bother the surgeons. Several minimal invasive approaches had been applied for radical tumor excision. The wound was forcibly enlarged for en-bloc specimen removal and prevention of debris sputtering.
We reported a case of huge tricuspid valve (TV) myxoma managed by robot-assisted endoscopic tumor resection and TV repair, with initial presentation of worsening shortness of breath for two months. The tumor was downsized with a morcellator and removed through a keyhole wound (1.1 cm in diameter). The patient recovered uneventfully and was discharged after four days.
With the first morcellator application, this might be the smallest surgical wound reported after the removal of a huge cardiac myxoma. The ICU and hospital stays were shortened. This might be effectively applied to further minimally invasive surgeries for cardiac tumor excision.
心脏黏液瘤是最常见的良性心脏肿瘤。其巨大的体积和脆弱的特性给外科医生带来了很大的困扰。已经采用了几种微创方法来彻底切除肿瘤。为了整块切除标本和防止碎屑飞溅，强行扩大了切口。
我们报告了 1 例巨大三尖瓣（TV）黏液瘤患者，采用机器人辅助内镜肿瘤切除术和 TV 修复术进行治疗，其初始表现为呼吸困难恶化 2 个月。使用组织捣碎器将肿瘤缩小，并通过一个钥匙孔大小的伤口（直径 1.1 厘米）取出。患者恢复顺利，4 天后出院。
首例组织捣碎器的应用，这可能是切除巨大心脏黏液瘤后报道的最小手术切口。重症监护病房和住院时间缩短。这可能有效地应用于进一步的微创心脏肿瘤切除术。
