颈动脉体恶性肿瘤的外科治疗

Guangchao Gu, Zhi-li Liu, Bao Liu, Changwei Liu, W. Ye, Yuexin Chen, L. Ni, R. Zeng, J. Shao, Xiao-jun Song, Yue-hong Zheng
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摘要

目的总结颈动脉体恶性肿瘤的外科治疗方法。方法对我院2005年3月至2019年11月收治的14例MCBT患者进行回顾性分析,收集影像学资料、手术记录、围手术期并发症及随访资料。结果男8例,女6例,平均年龄(40.8±11.3)岁。10例患者接受了CBT手术切除,其中1例仅接受肿瘤摘除,9例接受了颈内动脉重建,所有患者都接受了术中淋巴结活检。所有10名患者的肿瘤均被完全切除。无围手术期死亡或脑梗死发生。术中出血量为(955±658.5)ml。4例患者术后出现永久性神经损伤。随访时间1-132个月。没有脑梗塞或死亡的病例,重建的移植物仍然是专利的。除了2名患者在手术后出现肿瘤转移外,其他患者恢复顺利,没有疾病进展。结论手术仍是MCBT的主要治疗方法,但MCBT较大,Shamblin分级较先进。因此,颈动脉的完全肿瘤切除和重建是困难的。手术应寻求完全切除肿瘤,并进行颈部淋巴结活检以确定淋巴结转移。关键词:颈动脉体瘤;血管外科手术
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Surgical treatment of malignant carotid body tumor
Objective To summarize the surgical treatment of malignant carotid body tumor (MCBT). Methods A retrospective analysis of 14 MCBT patients admitted at our hospital from Mar 2005 to Nov 2019 was made, and the imaging data, surgical records, perioperative complications and follow-up data were collected. Results There were 8 males and 6 females, with an average age of (40.8±11.3) years. 10 patients underwent surgical resection of CBT, with one case undergoing tumor enucleation only, nine cases underwent internal carotid artery reconstruction, and all patients underwent intraoperative lymph node biopsy.Tumors were completely removed in all 10 patients. No perioperative death or cerebral infarction occurred. The intraoperative blood loss was (955±658.5) ml. Four patients had permanent nerve injury after surgery. The follow-up time ranged 1-132 months. There were no cases of cerebral infarction or death, and the reconstructed graft remained patent. Apart from the 2 patients who developed tumor metastasis after surgery, other patients recovered uneventfully with no disease progression. Conclusions Surgery is still the main treatment for MCBT, but MCBT is large and Shamblin class is more advanced. Therefore, complete tumor removal and reconstruction of the carotid arteries are difficult. Surgery should seek to completely remove the tumor and neck lymph node biopsy should be performed to determine the lymph node metastasis. Key words: Carotid body tumor; Vascular surgical procedures
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