静脉内平滑肌瘤病延伸至右侧心腔的诊断和外科治疗

目的探讨静脉内平滑肌瘤延伸至右侧心腔的诊断与外科治疗。方法2001年1月至2006年5月我院收治静脉内平滑肌瘤延伸至右侧心腔患者2例,均分期手术。首先行常规全麻中低温体外循环下心脏肿物切除术,然后二期切除子宫、附件及子宫病变组织,进行盆腔清扫术。结果无围术期并发症,2例患者随访至今情况良好。结论提高对多发性子宫肌瘤或右心房肿物的警惕性,一期直视下心脏内肿物切除术,二期切除子宫病变组织和盆腔清扫术,可获满意的效果。

Diagnosis and surgical treatment of intravenous leiomyomatosis extending through inferior vena cava into the right cardiac cavities

Objective To report the experience of diagnosis and surgical treatment of intravenous leiomyomatosis extending through inferior vena cava into the right cardiac cavities. Methods From Junuary 2001 to May 2006 ,2 patients with intravenous leiomyomatosis extending through inferior vena cava into the right cardiac cavities were treated stagedly in PUMCH . Firstly removal of tumer in the right cardiac cavities was performed using cardiopulmonary bypass under mid-hypothermia, and ,postoperatively 3-4weeks, total abdominal hysterectomy with bilateral salpingo-oophorectomy including the tumor mass was performed. Results The two patients have uneventful recovery ,no recurrence and no death in operation,the patients have shown a favorable outcome. Conclusion The leiomyomatosis should be suspected among patients with neoplasm in the righ atrium and multiple hysteromyoma.Successful therapy for intravenous leiomyomatosis is dependent on total two-stage surgical excision of the tumor.