原发性心脏肿瘤微创内窥镜手术切除术与缝合手术切除术的长期疗效比较

Nader S Aboelnazar, Brandon R Loshusan, Michael W A Chu
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引用次数: 0

摘要

目的:原发性心脏肿瘤并不常见,通常为良性,但有可能威胁生命。与传统的胸骨切开术(CS)相比,微创内窥镜(ENDO)技术已被证明是一种可行的肿瘤切除替代方法。本研究比较了一小批接受心脏肿瘤切除手术患者的临床和手术效果:2009年11月至2022年12月期间,34名患者连续接受了ENDO(21人)或CS(13人)技术的心脏肿瘤切除术。我们比较了早期围手术期结果、超声心动图结果以及长期临床和肿瘤复发结果:两组患者的基线特征相似,但ENDO组患者更年轻(56±16岁 vs 62±17岁),女性患者更多(83% vs 53%)。肿瘤位于左心房(19 例,56%)、右心房(5 例,15%)或任一心室(4 例,12%)。两组患者的院内死亡率和中风频率相似(n = 0)。心肺旁路或交叉钳夹时间、呼吸衰竭或肾衰竭、重症监护室或住院时间均无明显差异。随访期间(ENDO,42 [2 至 131] 个月 vs CS,54 [1 至 156] 个月),ENDO 组无死亡病例,CS 组有 2 名患者死亡(P = 0.21)。两组患者均无肿瘤复发:在选定的患者中,ENDO 和 CS 两种原发性心脏肿瘤切除术均安全、有效、持久,且早期和晚期效果相似。
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Long-Term Outcomes of Minimally Invasive Endoscopic Versus Sternotomy Surgical Resection of Primary Cardiac Tumors.

Objective: Primary cardiac tumors are uncommon, often benign, but can be potentially life threatening. Minimally invasive endoscopic (ENDO) techniques have been shown to be a feasible alternative for tumor resection compared with conventional sternotomy (CS). This study compared the clinical and surgical outcomes of a small series of patients undergoing cardiac tumor resection operations.

Methods: Between November 2009 and December 2022, 34 consecutive patients underwent cardiac tumor resection using either ENDO (n = 21) or CS (n = 13) techniques. We compared early perioperative outcomes, echocardiographic outcomes, and long-term clinical and tumor recurrence outcomes.

Results: Baseline characteristics were similar between groups; however, the ENDO group included younger patients (56 ± 16 vs 62 ± 17 years) and more female patients (83% vs 53%). The tumor was located in the left atrium (n = 19, 56%), right atrium (n = 5, 15%), or either ventricle (n = 4, 12%). In-hospital mortality and stroke frequency were similar for both groups (n = 0). There was no significant difference in cardiopulmonary bypass or cross-clamp times, respiratory or renal failure, or intensive care unit or hospital lengths of stay. At follow-up (ENDO, 42 [2 to 131] months vs CS, 54 [1 to 156] months), there were no deaths in the ENDO group and 2 patients died in the CS group (P = 0.21). No patients in either group experienced tumor recurrence.

Conclusions: In selected patients, both ENDO and CS approaches to primary cardiac tumor resection were safe, effective, durable, and associated with similarly good early and late results.

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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
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