University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany.
University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany.
Surg Oncol. 2023 Aug;49:101952. doi: 10.1016/j.suronc.2023.101952. Epub 2023 May 16.
Cardiac tumors are a rare and heterogeneous entity, with a cumulative incidence of up to 0.02%. This study aimed to investigate one of the largest patient cohorts for long-term outcomes after minimally-invasive cardiac surgery using right-anterior thoracotomy and femoral cardiopulmonary bypass (CPB) cannulation.
Between 2009 and 2021, patients who underwent minimally-invasive cardiac tumor removal at our department were included. The diagnosis was confirmed postoperatively by (immune-) histopathological analysis. Preoperative baseline characteristics, intraoperative data, and long-term survival were analyzed.
Between 2009 and 2021, 183 consecutive patients underwent surgery for a cardiac tumor at our department. Of these, n = 74 (40%) were operated on using a minimally-invasive approach. The majority, n = 73 (98.6%), had a benign cardiac tumor, and 1 (1.4%) had a malignant cardiac tumor. The mean age was 60 ± 14 years, and n = 45 (61%) of patients were female. The largest group of tumors was myxoma (n = 62; 84%). Tumors were predominantly located in the left atrium in 89% (n = 66). CPB-time was 97 ± 36min and aortic cross-clamp time 43 ± 24 min s. The mean hospital stay was 9.7 ± 4.5 days. The perioperative mortality was 0%, and all-cause mortality after ten years was 4.1%.
Minimally-invasive tumor excision is feasible and safe, predominantly in benign cardiac tumors, even in combination with concurrent procedures. Patients who require cardiac tumor removal should be evaluated for minimally-invasive cardiac surgery at a specialized center, as it is highly effective and associated with good long-term survival.
心脏肿瘤是一种罕见且异质性的实体瘤，累积发病率高达 0.02%。本研究旨在调查使用右前侧开胸和股动脉心肺旁路（CPB）插管进行微创心脏手术后最长时间的患者队列之一的结果。
在 2009 年至 2021 年期间，我们科室对接受微创心脏肿瘤切除术的患者进行了研究。术后通过（免疫）组织病理学分析确诊。分析了术前基线特征、术中数据和长期生存情况。
在 2009 年至 2021 年期间，我们科室共有 183 例连续患者接受了心脏肿瘤手术。其中 n=74（40%）采用微创方法进行手术。大多数患者（n=73；98.6%）为良性心脏肿瘤，1 例（1.4%）为恶性心脏肿瘤。平均年龄为 60±14 岁，n=45（61%）为女性。最大的肿瘤组为粘液瘤（n=62；84%）。肿瘤主要位于左心房，占 89%（n=66）。CPB 时间为 97±36min，主动脉阻断时间为 43±24min。平均住院时间为 9.7±4.5 天。围手术期死亡率为 0%，10 年后的总死亡率为 4.1%。
微创肿瘤切除术是可行且安全的，主要适用于良性心脏肿瘤，甚至可与同期手术联合进行。需要心脏肿瘤切除的患者应在专业中心评估微创心脏手术的可行性，因为它具有高度的有效性并与良好的长期生存相关。
