Xu Kai, Ma Zengshan, Li Bowen, Wang Zhenhua, Song Han, Bai Xiao, Meng Xiangbin, Liu Kai, Zhao Xin
Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China.
Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China.
JTCVS Tech. 2023 May 29;20:116-122. doi: 10.1016/j.xjtc.2023.04.018. eCollection 2023 Aug.
The study objective was to explore the feasibility and safety of totally endoscopic resection of a left ventricular tumor through small chest incisions without robotic assistance.
Four patients with a left ventricular tumor (1 papillary fibroelastoma, 1 lipoma, and 2 myxomas) underwent surgery with peripheral cardiopulmonary bypass. The mean age of patients was 58 ± 15 years. There were 3 female patients and 1 male patient. Through 3-port incisions in the right chest, pericardiotomy, bicaval cannulation, cardiac arrest, and atriotomy, left ventricular tumor resection was performed under thoracoscopy.
All patients had successful resections. The cardiopulmonary bypass and aortic crossclamp times were 110 ± 14 minutes and 58 ± 19 minutes, respectively. The length of stay in the intensive care unit was 38 ± 27 hours. There were no mortalities or complications in this cohort. Patients were discharged 7 days after the operation. Transthoracic echocardiography showed that the cardiac tumor was completely removed without any residue 3 months after surgery.
Totally endoscopic left ventricular tumor resection without a robotically assisted surgical system is feasible and reproducible. This technique could minimize surgical trauma and achieves complete tumor resection.
本研究旨在探讨在无机器人辅助的情况下，通过小切口胸腔镜完全切除左心室肿瘤的可行性和安全性。
4例左心室肿瘤患者（1例乳头状纤维弹性瘤、1例脂肪瘤和2例黏液瘤）接受了体外循环手术。患者的平均年龄为58±15岁。其中女性患者3例，男性患者1例。通过右胸的三切口，进行心包切开、双腔静脉插管、心脏停搏和心房切开，在胸腔镜下进行左心室肿瘤切除术。
所有患者均成功切除肿瘤。体外循环时间和主动脉阻断时间分别为110±14分钟和58±19分钟。重症监护病房的住院时间为38±27小时。该队列中无死亡病例或并发症发生。患者术后7天出院。经胸超声心动图显示，术后3个月心脏肿瘤完全切除，无任何残留。
在没有机器人辅助手术系统的情况下，完全内镜下左心室肿瘤切除术是可行且可重复的。该技术可最大限度地减少手术创伤，并实现肿瘤的完全切除。
