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目的总结侵及胸、腹部大血管的肿瘤治疗过程中血管外科技术的临床应用及其疗效。方法2001年1月至2005年12月,23例病人因肿瘤侵及胸、腹部大血管而行血管成形或重建术。结果行肿物根治性切除19例,切除率达82.6%;行姑息性切除术4例,切除率17.4%。全组无术中死亡,围术期并发症发生7例次,发生率30.4%。全组随访20例(86.9%),失访3例,最长随访63个月。围术期死亡4例,病死率17.4%。截至2005年8月,全组术后生存40d～59个月,生存48个月以上3例,36个月以上4例,24个月以上6例,12个月以上9例,6个月以上12例;通过影像学检查手段了解移植血管通畅程度、肿瘤复发和转移情况,2例人工血管血栓形成,其余病例均无并发症。结论病例选择恰当,尽量行肿瘤根治性切除并进行大血管重建,可提高病人生存率和生活质量。
Objective To summarize the clinical application of vascular surgery and its curative effect in the treatment of tumors that invade the thoracic and abdominal large vessels. Methods From January 2001 to December 2005, 23 patients underwent angioplasty or reconstruction due to tumor invasion of the thoracic and abdominal large vessels. The results of radical resection of the tumor in 19 cases, resection rate of 82.6%; line palliative resection in 4 cases, resection rate of 17.4%. No death in the whole group, perioperative complications occurred in 7 cases, the incidence of 30.4%. The whole group was followed up in 20 cases (86.9%), lost in 3 cases, the longest follow-up of 63 months. Perioperative death in 4 cases, fatality rate of 17.4%. As of August 2005, the whole group survived for 40 days to 59 months and survived for more than 48 months in 3 cases, 36 cases over 4 months, 6 cases over 24 months, 9 cases over 12 months and over 6 months Twelve cases were followed up. The extent of graft patency and tumor recurrence and metastasis were observed by imaging examination. Two cases of artificial blood vessel thrombosis were found. No complications were found in the other cases. Conclusion The appropriate choice of cases, as far as possible radical tumor resection and reconstruction of the great vessels can improve patient survival and quality of life.