摘要
目的探讨和总结采用血管切除重建治疗癌性上腔静脉综合征的临床经验,并评价其疗效。方法2002年1月至2005年1月,手术治疗癌性上腔静脉综合征16例,其中局部晚期肺癌6例、晚期肺癌1例、侵袭性胸腺瘤4例、精原细胞瘤3例、非霍奇金淋巴瘤2例。术中行原发肿瘤和受累上腔静脉全部或部分切除并重建上腔静脉,其中采用人工血管置换14例,人工血管旁路2例。结果全组无手术死亡及术后早期死亡。平均随访23.57个月,无阻塞症状复发,患者1、2、3年生存率分别为84.6%(11/13)、66.7%(6/9)、40.0%(2/5)。结论上腔静脉切除重建能安全有效地解除梗阻症状,显著地提高和延长患者的生存质量及生存时间,但必须严格把握其手术适应证。
Objective To evaluate and summarize the clinical experience of the vessel resection and reconstruction in surgical management of malignant superior vena cava syndrome （SVCS）. Methods From January 2002 to January 2005.16 patients with malignancy invading the superior vena cava（SVC） underwent surgical intervention. Among them locally advanced lung cancer was in 6 cases, advanced lung cancer in 1 , invasire thymoma in 4, seminoma in 3 and non-Hodgkin lymphoma in 2. The primary tumor was totally or partially resected in all patients. Replacement and bypass of the SVC with Gore-Tex vascular prosthesis was performed respectively in 14 and 2 patients. Results All the cases had no intraoperative and early postoperative death. Fifteen of the 16 patients were followed up for 23.57 （7 -43 ） months and superior vena cava obstruction （SVCO） symptom did not be observed. The overall survival rates of 1, 2 and 3 years were 84.6% （11/13）, 66.7% （6/9） and 40. 0% （2/5） , respectively. Conclusion The SVC system resection and reconstruction is a safe and effective therapy and can significantly improve the quality of life and increase the survival time for properly selected patients.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2005年第24期2450-2452,共3页
Journal of Third Military Medical University
