Surgical treatment of pulmonary artery sarcoma
Surgical treatment of pulmonary artery sarcoma
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DOI：
10.1016/j.jtcvs.2011.03.013
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发表时间：
2011-12-01
影响因子：
6
通讯作者：
Wang, Pi-Shan
中科院分区：
文献类型：
--
作者：
Gan, Hui-Li;Zhang, Jian-Qun;Wang, Pi-Shan
目的：本研究的目的是描述肺动脉肉瘤的预后前景，并探讨远端栓子切除术对肺动脉肉瘤外科治疗预后的影响。方法：9例肺动脉肉瘤患者在安贞医院手术治疗，并回顾性分析。5例患者仅接受肺动脉肉瘤切除术，4例患者同时接受肺动脉肉瘤切除术和远端栓子切除术。结果：无院内死亡。4例患者出现肺缺血再灌注损伤，其中3例在延长通气和呼气末正压支持下恢复，1例在体外膜肺氧合支持下恢复。随访期间，5例未行远端取栓术的患者于术后6~29个月死亡，中位生存时间为10个月。在接受远端栓子切除术的4例患者中，3例在术后30、37和43个月死亡，1例在术后39个月仍存活。所有8例死亡都是由于局部或全身复发。行远端栓子切除术的患者的生存时间长于未行远端栓子切除术的患者（log-rank检验，x（2）= 7.914，P = 0.005）。结论：根治性手术切除为肺动脉肉瘤患者提供了唯一的生存机会，远端栓子切除术可能进一步延长这些患者的生存期。（《胸血管外科杂志》2011; 142：1469 - 72）
Objective: The study objectives were to characterize the prognostic perspectives of pulmonary artery sarcoma and to investigate the effect of distal embolectomy on the prognosis of surgical treatment of pulmonary artery sarcoma.Methods: Nine patients with pulmonary artery sarcoma were surgically treated at Anzhen Hospital, and the data were retrospectively reviewed. Five patients underwent only pulmonary artery sarcoma resection, and 4 patients underwent both pulmonary artery sarcoma resection and distal embolectomy.Results: There was no in-hospital mortality. Four patients had lung ischemia-reperfusion injury, 3 of whom recovered with the support of extended ventilation and positive end-expiratory pressure, and 1 of whom recovered with extracorporeal membrane oxygenation support. During the follow-up, 5 patients who did not undergo distal embolectomy died 6 to 29 months after the procedure, with a median survival time of 10 months. Of the 4 patients undergoing distal embolectomy, 3 died 30, 37, and 43 months after the procedure, and 1 is still alive 39 months after the procedure. All 8 deaths were due to local or systemic recurrence. The patients who underwent distal embolectomy lived longer than the patients who did not undergo distal embolectomy (log-rank test, x(2) = 7.914, P = .005).Conclusions: Radical surgical resection provides the only chance of survival for patients with pulmonary artery sarcoma, and distal embolectomy may further extend survival for these patients. (J Thorac Cardiovasc Surg 2011;142:1469-72)