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首页> 外文期刊>Journal of the Hong Kong College of Cardiology >Surgery for Cardiac Tumors (Primary and Secondary) - Clinical Experience and Surgical Results in 22 Patients: Queen Elizabeth Hospital
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Surgery for Cardiac Tumors (Primary and Secondary) - Clinical Experience and Surgical Results in 22 Patients: Queen Elizabeth Hospital

机译：心脏肿瘤的手术（初级和中学） - 22例患者的临床经验和手术结果：伊丽莎白女王医院

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Purpose: Retrospective review of surgical management of the 22 cardiac tumors resected in Queen Elizabeth Hospital during the period of March 1995-December 2002. Methods: Presenting symptoms, diagnostic data, anatomical findings, surgical techniques, morbidity and complications of surgery were recorded. Follow up data was retrieved from out-patient records. Results: There were 12 male (54.5%) and 10 female (45.4%) patients. Median age was 61. 50% (11/22) of the cases were myxoma. Of the remaining cases, 27.3% (6/22) were various types of secondary metastastic tumor, 13.6% (3/22) were tumor of mediastinum with cardiac invasion, and 9.1% (2/23) were primary malignancy. Left sided masses were dominated by myxoma, which were sited either on the inter-atrial septum (81.8%) or left atrium (18.1 %). All other tumor groups were found on the right side. Dyspnea (81.9%) was the most common presenting symptom, followed by chest pain (31.8%), embolic events (13.6%) and superior vena cava obstruction. All tumors were resected with cardiopulmonary bypass under moderate hypothermia, undertaken via either right atriotomy, superior septal and trans-septal with full thickness excision. The average cross-clamp time and bypass time were 48.6 minutes and 101.4 minutes respectively. The average blood loss was 813 ml. Post-operatively, 2 of the cases were complicated by junctional bradycardia and one of them required permanent pacing. Other complications including pericardial effusion, superior vena cava obstruction, pneumonia, secondary hemorrhage had been reported. The average follow up period was 40 months ranging from 3 months to 8 years. All patients with primary benign myxoma remained asymptomatic except one died 3 years after surgery. This patient had known co-existing history of breast cancer. She suffered from embolic complications and finally succumbed from multiple organ failure. All patients with secondary neoplasms died during the course of follow-up. One with germ cell tumor was lost to follow up. Survival for primary benign tumors and cardiac metastasis from secondary tumors, were 34 and 6 months respectively. The median survival of all tumors was 25 months. Surgical resection, when possible, is the treatment of choice for all patients with cardiac neoplasms. It is curative in benign tumors. On the other hand, palliative surgical procedures may be carried out for malignant tumors for relief of obstructive symptoms and allow time for adjuvant therapy.
机译：目的：在2002年3月期间，伊丽莎白女王医院切除22例心脏肿瘤手术治疗的回顾性综述。方法：记录症状，诊断数据，解剖学发现，手术的外科手术，发病率和并发症。从远程患者记录中检索跟踪数据。结果：12名男性（54.5％）和10名女性（45.4％）患者。中位年龄为61. 50％（11/22）的病例是肌瘤。在其余情况下，27.3％（6/22）是各种类型的二级转移肿瘤，13.6％（3/22）是含有心脏侵袭的亚氨intinum的肿瘤，9.1％（2/23）是原发性恶性肿瘤。左侧肿块由脊椎占据主导，脊髓瘤是口腔间隔内（81.8％）或左上核（18.1％）。在右侧发现所有其他肿瘤基团。呼吸困难（81.9％）是最常见的呈现症状，其次是胸痛（31.8％），栓塞事件（13.6％）和高级腔静脉梗阻。在适度的低温下，通过右半疗法进行心肺旁路，通过右半疗法，优质的隔膜和反式隔膜进行全肿瘤切除所有肿瘤。平均交叉钳位时间和旁路时间分别为48.6分钟和101.4分钟。平均失血为813毫升。可操作性地，其中2例被连接性心动过缓复杂，其中一个需要永久起搏。报道了其他并发症，包括心包积液，高级腔静脉梗阻，肺炎，二次出血。平均随访时间为40个月，从3个月到8年。所有良性良性肌瘤的患者仍然是无症状，除了手术后3年死亡。该患者已知具有乳腺癌的共同存在历史。她患有栓塞并发症，最后从多器官失败中丧生。所有次生肿瘤的患者在随访过程中死亡。毒细胞肿瘤的一种丢失了跟进。来自次级肿瘤的原发性良性肿瘤和心脏转移的存活分别为34和6个月。所有肿瘤的中位生存期为25个月。在可能的情况下，手术切除是治疗所有心肌肿瘤的患者的选择。它是良性肿瘤的疗效。另一方面，可以对恶性肿瘤进行姑息性外科手术，以缓解阻塞性症状并留出时间进行佐剂治疗。

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