肿瘤侵犯大血管的治疗探讨

目的：总结在侵及大血管肿瘤的治疗过程中血管外科技术的临床应用经验.方法：回顾性分析2005年1月～2012年6月在我院应用血管外科技术手术治疗10例侵犯大血管肿瘤患者的临床资料.单纯侵犯血管壁者5例,单纯血管内瘤栓或血栓者2例,同时侵犯血管壁和瘤栓者3例.结果：10例患者均接受了外科治疗,术式包括肿瘤血管粘连松解6例,血管切除直接缝合1例,人工血管补片2例,心包补片1例,人工血管置换3例,腔内瘤栓取栓3例.肿瘤根治性切除7例,姑息性切除3例,完整切除率为70％,无术中死亡,围术期死亡0例.获随访10例,失访0例,随访率100％.截至2012年6月,本组病例术后生存期7年以上4例,5年以上5例,2年以上7例,半年以上10例,死亡原因多为肿瘤全身转移,疗效最好的为腹股沟淋巴结核粘连压迫股动脉.结论：肿瘤累及大血管时可以通过多种血管外科技术的综合运用提高肿瘤切除成功率和术后生存质量.

Surgical Strategies on Tumors Invading Great Vessels

Objective： To summarize vascular surgical strategies on treating tumors invading of the great vessels. Methods： Retrospective analysis the clinical data from January 2005 to June 2012 in our hospital of vascu- lar surgery 10 cases of surgical treatment of tumors invading of the great vessels. A simple invasion of the vessel wall that there were 5 cases, simple intravascular tumor thrombus or blood clots in 2 cases, while invasions of the vascular wall and tumor thrombus in 3 patients. Results： 10 patients have received surgical treatment, surgi- cal adhesion lysis, including 6 cases of tumor blood vessels, vascular resection direct suture of I case, 2 cases of artificial blood vessel patch, pericardial patch in 1 case, artificial vascular replacement or bypass in 3 cases, cavi- ty thrombectomy in 3 cases of tumor thrombus. 7 cases of radical tumor resection, palliative resection in 3 cases,complete resection rate was 70 %, no intraoperative mortality, perioperative death of 0 cases. Were followed up 10 cases, zero cases lost to follow - up rate of 100%. As of June 2012, this group of patients survival period of 7 years or more in 4 cases, more than 5 years in 5 cases, more than 2 years in 7 cases, more than 0.5 years in 10 cases of. Multiple causes of death in the body is tumor metastasis, The best efficacy cancer is Groin scrofulous adhesion oppression the artery. Conclusion：Tumors involving major blood vessels can be through a variety of vascular surgical techniques to improve the success rate of tumor resection and postoperative quality of life.