肿瘤侵及重要血管的手术治疗

Surgical Treatment of Tumor Invading Vital Vessels

目的总结应用血管外科技术手术治疗肿瘤侵及大血管时的临床经验。方法回顾性分析2001年1月—2007年8月应用血管外科技术手术治疗30例患者的临床资料。结果 30例患者接受了外科手术治疗,术式包括人工血管置换、补片成形及瘤栓取出等。其中行肿瘤根治性切除27例,姑息性切除3例,均一次手术成功,无二次手术。围手术期死亡5例,无术中死亡,死亡率16.7%。获随访25例,失访5例,随访率83.3%,随访时间1天～57月。截至2007年8月,生存48月以上3例,36月以上5例,24月以上7例,12月以上10例,6月以上14例,3月以上17例。结论运用血管外科技术能够提高侵及重要血管的肿瘤根治性切除率及手术安全性。

Objective To summarize the clinical experience in applying vascular surgical techniques to treat the tumors with the vital vessels invasion.Methods The clinical data of 30 patients with vital vessels involved by tumors who had been treated by vascular surgical techniques from Jan.2001 to Aug.2007 were analyzed retrospectively.Results Thirty patients were subjected to surgical procedures including artificial blood vessels replacement,patch plasty,tumor thrombectomy and so on.Twenty-seven cases（90%） experienced radical resections and3 cases（10%）underwent palliative resections.Five cases（16.7%）died perioperatively.Twenty-five cases（83.3%）were followed up from1 day to 57 months.Up to Aug.2007,3 cases（10%）survived more than 48 months,5 cases（16.7%）more than 36 months,7 cases（23.3%） more than 24 months,10 cases（33.3%）more than 12 months,14 cases（43.7%）more than 6 months and 17 cases（56.7%）more than 3 months.Conclusion Surgical treatment of tumors invading the vital vessels by vascular surgical techniques could enhance the possibility of radical resection and operative safety.