Asaroğlu Abdussamet, Temiztürk Zeki, Güneş Gökhan, Yanartaş Mehmed
Department of Cardiovascular Surgery, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):085-85. doi: 10.5606/tgkdc.dergisi.2024.msb-61. eCollection 2024 Nov.
This study aimed to share our experience with patients with heart disease requiring open heart surgery who also had a concomitant lung mass.
This retrospective study included 22 patients (20 males, 2 females; mean age: 63.6 years; range, 43 to 79 years) who required open heart surgery and had a detected lung mass during preoperative evaluation. All the patients were discussed between cardiac and thoracic surgery teams, and different approaches according to patient and mass characters were chosen. Thoracic computed tomography and positron emission tomography scans and, when needed, biopsies were used to determine mass characters.
Seven patients were deemed to have small benign nodules, and it was decided not to intervene on the mass. A biopsy before surgery was performed in two patients, and an intervention was not deemed necessary in these patients. One patient was evaluated as having late-stage lung cancer, and no cardiac surgical intervention was performed. Ten patients underwent cardiac surgery and lung resections or lobectomies in a simultaneous operation. Two of the patients subsequently underwent a separate thoracic surgery after the cardiac surgery. There was no perioperative mortality or myocardial infarction.
Managing patients with both cardiac disease requiring surgery and a lung mass is complex and necessitates a multidisciplinary approach. The decision to perform combined surgery or staged procedures should be individualized based on patient-specific factors, the nature of the lung mass, and the urgency of the cardiac condition. While outcomes for combined procedures are generally favorable in well-selected patients, they require meticulous perioperative planning and long-term follow-up.
本研究旨在分享我们对需要进行心脏直视手术且同时伴有肺部肿块的心脏病患者的治疗经验。
这项回顾性研究纳入了22例患者(20例男性,2例女性;平均年龄:63.6岁;范围为43至79岁),这些患者需要进行心脏直视手术,且在术前评估中发现有肺部肿块。所有患者均在心脏外科和胸外科团队之间进行了讨论,并根据患者和肿块的特征选择了不同的治疗方法。采用胸部计算机断层扫描和正电子发射断层扫描,必要时进行活检以确定肿块特征。
7例患者被认为有小的良性结节,决定不对肿块进行干预。2例患者在手术前进行了活检,这些患者被认为无需干预。1例患者被评估为患有晚期肺癌,未进行心脏外科手术干预。10例患者在同一手术中接受了心脏手术和肺切除或肺叶切除术。其中2例患者在心脏手术后随后接受了单独的胸外科手术。围手术期无死亡或心肌梗死发生。
对患有需要手术的心脏病和肺部肿块的患者进行管理很复杂,需要多学科方法。决定进行联合手术或分期手术应根据患者的具体因素、肺部肿块的性质和心脏疾病的紧迫性进行个体化。虽然联合手术在精心挑选的患者中通常效果良好,但它们需要精心的围手术期规划和长期随访。