REFLECTIONS ON SURGICAL TREATMENT OF 214 CASES OF PRIMARY MEDIASTINAL TUMOR

Our hospital documented 214 cases of primary mediastinal tumor from May 1957 to July 1995. They were treated surgically, There were 184 benign cases (85. 98% ), and 30 malignant cases (14.02 % ). Among them, there were 63 cases of neurogenic tumor (29.43 % ), 48 cases of thymic tumor (22. 4% ), 41 cases of teratoid tumor (19. 16% ), 12 cases of bronchial cyst (5. 61% ), and 9cases of intrathoracic adenoma of thyroid (4. 21%). The authors mainiy discuss the early diagnosis,tumor variety, operating incisions, and operating essentials.

Surgically treated primary malignant tumor of small bowel:A clinical analysis

AIM:To evaluate the clinical presentation,treatment and survival of patients with primary malignant tumor of small bowel(PMTSB).METHODS:Clinicopathologic data about 141 surgically treated PMTSB patients(91 males and 50 females) at the median age of 53.5 years(range 23-79 years) were retrospectively analyzed.RESULTS:The most common initial clinical features of the patients were intermittent abdominal discomfort or vague abdominal pain(67.4%),abdominal mass(31.2%),bowel obstruction(24.1%),hemotochezia(21.3%),jaundice(16.3%),fever(14.2%),coexistence of bowel perforation and peritonitis(5.7%),coexistence of gastrointestinal bleeding and shock(5.0%),and intraabdominal bleeding(1.4%).Ileum was the most common site of tumor(44.7%),followed by jejunum(30.5%)and duodenum(24.8%).PMTSB had a nonspecific clinical presentation.Segmental bowel resection(n=81)was the most common surgical procedure,followed by right hemicolectomy(n=15),pancreaticoduodenectomy(n=10),and others(n=19).Twenty-seven adenocarcinoma patients and 13 malignant lymphoma patients received adjuvant chemotherapy with 5-fluorouracil and cyclophosphamide,adriamycin,vincristine and prednisone,respectively.Information about 120 patients was obtained during the follow-up.The median survival time of PMTSB patients was 20.3 mo.The 1-,3-and 5-year survival rate was 75.0%(90/120),40.0%(48/120)and 20.8%(25/120),respectively.Adenocarcinoma was found in 73.7%(42/57),21.1%(12/57)and 15.8%(9/57)of the patients,respec-tively.Gastrointestinal stromal tumor was observed in 80.0%(20/25),72.0%(18/25)and 36.0%(9/25)of the patients,respectively.Carcinoid was detected in 100.0%(15/15),80.0%(12/15)and 46.7%(7/15)of the patients,respectively.Malignant lymphoma was demonstrated in 69.2%(9/13),30.8%(4/13)and 0%(0/13)of the patients,respectively.CONCLUSION:En bloc resection is the principal therapy for most PMTSB and chemotherapy is the important treatment modality for malignant lymphoma and other malignant tumors of small bowel which cannot be radically removed.

Comprehensive treatment for primary right renal diffuse large B-cell lymphoma with a renal vein tumor thrombus:A case report

BACKGROUND Renal involvement in lymphoma is commonly associated with widespread nodal or extranodal lymphoma.Primary renal diffuse large B-cell lymphoma is an extremely rare extranodal lymphoma,accounting for fewer than 1%of all renal masses.Interestingly,the patient in this study had a renal vein tumor thrombus that was observed after laparoscopic radical nephrectomy.CASE SUMMARY We report the case of a 56-year-old female patient with primary renal lymphoma and a renal vein tumor thrombus whose first symptom was right pain in the back and gross hematuria.Histopathology revealed primary renal diffuse large B-cell lymphoma.The patient received 8 standard cycles of rituximab with cyclophosphamide,doxorubicin,vincristine,and prednisone chemotherapy after surgery,and no obvious signs of recurrence were observed during the one-year follow-up.CONCLUSION We evaluated comprehensive treatment of primary renal diffuse large B-cell lymphoma and multidisciplinary management of this malignancy.

Clinical characteristics and outcome of primary hepatic neuroendocrine tumors after comprehensive therapy

BACKGROUND Primary hepatic neuroendocrine tumors(PHNETs),a group of neuroendocrine neoplasms,are extremely rare.There are only few case reports about PHNETs in the literature.The lack of large samples and multicenter research results in poor diagnostic and therapeutic approaches.AIM To discuss the clinical characteristics,diagnosis,and treatment of PHNETs and risk factors related to survival.METHODS We retrospectively analyzed the clinical data,imaging features,immunohistochemistry data,and treatment efficacy of 40 patients who were pathologically diagnosed with PHNETs and admitted to The First Affiliated Hospital of Zhengzhou University from January 1,2014 to November 15,2019.Finally,survival analysis was performed to identify the risk factors for survival.RESULTS The main symptoms and signs included intermittent abdominal pain(19 patients,47.5%)and bloating(8 patients,20.0%).The positive rates of tested tumor markers were recorded as follows:Carbohydrate antigen 19-9(CA19-9)(6 patients,15.0%),CA72-4(3 patients,7.5%),carcinoembryonic antigen(7 patients,17.5%),and alpha-fetoprotein(6 patients,15.0%).Immunohistochemical staining results showed positivity for Syn in 38(97.4%)of 39 patients,for chromogranin A in 17(65.4%)of 26 patients,for CD56 in 35(94.6%)of 37 patients,for AE1/AE3 in 28(87.5%)of 32 patients,and for Ki-67 in all 40(100.0%)patients.The overall survival rate was significantly related to the tumor grade,AE1/AE3,and Ki-67.tumor number,tumor size,metastasis,and treatment)and overall survival.CONCLUSION Higher grade,negative AE1/AE3,and higher Ki-67 are associated with a worse survival rate.Kinds of treatment and other parameters have no significant influence on overall survival.

Diagnosis and treatment of mixed glioma

The authors present 83 patients with mixed glioma with experiences in clinical diagnosis and treatment.In all these cases.there were 44 tumors as grade 1 or 2,and 39 as grade 3 or 4.In 39 tumors.two glial components(oligodendrocytes and astrocytes) occurr

A case of simultaneous triple primary gastrointestinal tumor

Multiple primary carcinoma which is the same organ of the same patient or multiple organs, tissues has occurred two or more than two kinds of the primary malignant tumor. All cancer at the same time or 6 months from diagnosis is called simultaneous multiple primary carcinoma. In this case the patient suffering from cancer including rectal cancer, colon cancer and appendix gastrointestinal stromal tumor(GIST) three primary carcinoma, is simultaneous multiple primary carcinoma and it's extremely rare on the clinical cases. This report address that the incidence of the patient with operation and pathological diagnosis.

Case of primary extracranial meningioma of the maxillary sinus presenting as buccal swelling associated with headache:A case report

BACKGROUND Meningiomas are benign tumors that originate from the meningothelial arachnoid cells,but they rarely develop extracranially.There is no specific surgical guideline for resecting them in the maxillary sinus,and little is known about their biological behavior and operative management.CASE SUMMARY We present a 54-year-old female patient referred to our department with a primary extracranial meningioma that presented as buccal swelling associated with headache.On clinical examination the mass was non-tender,fixed,sessile and non-pulsatile situating in the right maxillary sinus.Computed tomography scan showed a well-defined mass of 7 cm×6 cm×6 cm compressing the surrounding structures.Magnetic resonance imaging revealed a well circumscribed heterogenous lesion with necrotic center and relatively hypointense on T2-weighted imaging.Imaging studies revealed no evidence of intracranial extension and metastatic nests.Biopsy showed grade I primary extracranial with low mitotic activity.Total maxillectomy with excision of tumor and adjacent paranasal structures following reconstruction of the orbit and maxilla with tissue patch was done by the maxillofacial surgeon.The biopsy reported fibrous meningioma based on the hematoxylin and eosin section.On immunohistochemistry the tumor cells were positive for vimentin,focally positive for epithelial membrane antigen and CD99 and negative for signal transducer and activator of transcription 6.The mass was removed surgically with reconstruction,and the pathological studies confirmed the diagnosis to be an extracranial meningioma.The present study briefly reviews the current knowledge concerning the diagnosis and treatment of extracranial meningiomas in the head and neck area and offers suggestions for managing extracranial meningiomas in the paranasal sinuses.CONCLUSION To conclude,extracranial meningiomas in the paranasal sinuses may be successfully managed by surgical treatment without evident post-surgery complications.

Analysis of the successful clinical treatment of 140 patients with parathyroid adenoma:A retrospective study

BACKGROUND Parathyroid adenoma(PA) sometimes recurs after surgery,how to improve the surgical success rate of PA is the key to the treatment of this disease.AIM To investigate the clinical features,diagnosis,and surgical treatment of patients with PA.METHODS Patients who were pathologically confirmed with PA and had undergone surgery for the first time between January 2010 and December 2017 at the Beijing Shijitan Hospital affiliated to Capital Medical University were included in the study.The clinical features,localization diagnosis,and surgical treatment of these patients were analyzed.RESULTS Of the 140 patients,32 were male and 108 were female;132 cases had one adenoma,and 8 had two adenomas.In addition,114 cases had clinical symptoms,among which 51,28,23,8,and 4 had urinary system,skeletal system,digestive system,neuromuscular system,and neuropsychiatric symptoms,respectively,while 26 cases had no obvious symptoms.The median level of preoperative parathyroid hormone(PTH) was 201.0 pg/m L.The positive detection rate of technetium-99m sestamibi(Tc-99m MIBI) single-photon emission computed tomography/computed tomography(SPECT/CT),ultrasound examination,and the combined use of Tc-99m MIBI SPECT/CT and ultrasound examination was 92.9%,85.5%,and 96.4%,respectively.Open surgery was performed in all patients,and PTH was monitored during surgery.The success rate of surgery was 98.6%.After surgery,21 cases developed hypocalcemia,1 case developed temporary hoarseness,and 19 cases had transient hypoparathyroidism but there was no permanent hypoparathyroidism,postoperative hemorrhage,or hematoma in the surgical area.CONCLUSION For patients with clinically unexplained skeletal system,urinary system,and neuropsychiatric symptoms,the possibility of PA should be considered.Imaging examinations such as ultrasound and Tc-99m MIBI SPECT/CT could be integrated before surgery to obtain accurate localization diagnosis.Precise preoperative localization,intraoperative PTH monitoring,and delicate surgery to protect the integrity of the PA capsule ensure a minimally invasive and successful surgery.

Surgical strategy for presacral tumors： analysis of 33 cases

Background Presacral tumors are highly infrequent tumors located in the space known as presacral or retrorectal space. Although there have been substantial improvements in the prognosis of patients with malignant presacral tumors, the development of newer surgical strategy is likely to further improve the oncologic outcomes of malignant presacral tumors. The aim of this article was to report our experience in 33 cases, and to review the surgical strategy, pathological features and the prevention of complications from our experience. Methods A retrospective analysis was conducted on 33 cases （20 male and 13 female） with presacral tumors surgically treated in our hospital between January 1998 and April 2009. The surgical approaches included trans-abdominal in 10 cases （30%）, trans-sacral in 18 cases （55%） and combined abdominal-sacral in 5 cases （15%）. All patients got followed up （14-123 months, mean of 45.1 months）. At last, the general information, clinical symptoms, histodiagnosis, surgical types and postoperative complications of all cases in our series were assessed. Results Ages of 33 patients ranged from 18 to 71 years, with an average of 48.5 years. Pathological findings： 6 epidermoid cysts, 5 teratomas, 3 leiomyomas, 9 neurofibromas, 5 neurilemmomas, 1 enterogenous cyst, 1 liposarcoma, 1 leiomyosarcoma, 1 angiosarcoma, and 1 neurofibrosarcoma. All tumors were excised with no perioperative death. A colostomy was taken in one case with angiosarcoma involving the rectum because of the intraoperative injury of the rectum. Blood loss during surgery was 400-11 000 ml （mean of 2400 ml）. Four （12%） cases had local recurrence during follow-up： 2 because of inadequate drainage after dermoidectomy, both of them were cured by surgical resection and drainage; recurrence occurred in a case of teratoma in 18 months after surgery, cured by a trans-sacral excision; local recurrence and lung metastasis occurred simultaneously in a case of angiosarcoma in 6 months postoperatively and the patient died one month later of respiratory failure. Conclusions The main treatment of most presacral tumors is surgical resection. Selection of surgical approach is very important for complete resection of the presacral tumors. The location, size and peculiarities of tumors, conditions of the skin and soft tissues and the patients＇ somatotype are all determinative factors. Multidisciplinary cooperation is also very necessarv.

同时性多原发性结直肠癌六例诊治体会

目的总结同时性多原发性结直肠癌(synchronous colorectal carcinoma,SCC)的诊治方法。方法回顾分析我院2021年3月~2021年7月收治的6例SCC并进行手术治疗的病人临床资料。结果6例SCC病人均顺利行一期手术切除、吻合,病人恢复顺利,无吻合口漏等严重并发症。结论对SCC病人根据肿瘤部位选择合适的手术方式,治疗效果满意。

左心房多发滑膜肉瘤1例

目的探讨左心房多发滑膜肉瘤患者的临床特点和治疗方法。方法回顾性分析1例左心房多发滑膜肉瘤患者的临床资料。结果活动后出现胸闷、气促伴腹泻4 d为急诊就诊症状,以“急性左心衰竭”入院,心脏彩超示左心房多发实质性占位病变,阻塞二尖瓣口致二尖瓣重度狭窄;增强胸部电子计算机断层扫描(CT)显示肿物轻度均匀强化,经多学科会诊讨论后,行手术切除肿瘤及累及的二尖瓣,植入一枚人工生物二尖瓣;术后病理诊断心脏滑膜肉瘤。结论原发性心脏滑膜肉瘤临床上较为罕见,临床表现复杂多样,在无远处转移的情况下,手术切除肿瘤为治疗首选。

盆腔腹膜后肿瘤临床病例分析

目的:探讨盆腔腹膜后肿瘤(primary pelvic retroperitoneal tumor,PPRT)的诊疗及预后。方法:回顾性分析2000年10月至2021年5月于天津医科大学肿瘤医院诊治的31例PPRT患者的临床病理资料。结果:术前31例患者均行MRI或CT检查,7例提示肿物位于腹膜后,1例因肿物体积大且血管丰富,术前行超声引导下肿物穿刺确诊为肉瘤。31例患者均行手术治疗,其中良性肿瘤15例、恶性肿瘤16例。良性肿瘤以畸胎瘤(5/15)及神经鞘瘤(3/15)多见,良性肿瘤均完整切除;恶性肿瘤以肉瘤(9/16)多见,11例完整切除、5例姑息切除。胚胎残留组织来源的肿瘤均位于正中部位且良性多为囊性,间叶组织及神经组织来源肿瘤多位于侧位且多数具有实性成分。良性肿瘤患者的平均年龄为42.1岁,恶性肿瘤的为49.7岁。随访期内,15例良性肿瘤中14例未复发,1例复发后完整切除;16例恶性肿瘤中4例失访,4例死于该病,2例发生2次复发(2例均行手术),6例未复发。结论:PPRT易漏诊或误诊,鉴别诊断需结合临床特点、妇科检查及影像学检查。超声引导下肿物穿刺有利于在术前制定治疗方案,首选彻底手术切除方法。

骶前肿瘤临床病理及手术入路选择分析

目的探讨骶前肿瘤的诊断及外科治疗方法。方法回顾性分析2003年~2009年经手术和病理证实的19例骶前肿瘤的临床资料。19例骶前肿瘤患者,术前行直肠指检及影像学检查明确定位诊断,单纯经腹手术2例,单纯经骶手术15例,经腹经骶联合手术2例。结果 19例患者全部为良性肿瘤,切口一期愈合17例,术后并发切口感染2例,经持续负压引流后二期治愈。全组无围术期死亡病例。19例中有16例术后获随访5个月~14个月,2例经骶手术者复发,再行手术切除治愈。结论直肠指检、影像学检查是骶前肿瘤的主要诊断方法,可指导手术方式;经骶途径切除骶前肿瘤安全、可靠。

原发性骶骨肿瘤的手术治疗

目的:总结手术治疗原发性骶骨肿瘤的临床经验。方法:1991年1月～2009年8月我科手术治疗26例原发性骶骨肿瘤患者,男17例,女9例。就诊时年龄17～71岁,平均48岁。术前结合临床表现、影像学和CT引导下穿刺活检病理结果明确诊断。肿瘤累及S2及以上者15例,采用前后联合入路手术,其中9例瘤体巨大的恶性肿瘤患者术前置入主动脉球囊术中行腹主动脉临时阻断;肿瘤累及S3及以下者11例,采用单纯后路手术。术中尽量保留双侧S2及以上神经根和一侧S3神经根。9例切除S1椎患者同时行腰椎髂骨内固定。结果:所有患者均顺利完成手术,无围术期死亡及严重术中并发症。单纯后路手术患者术中出血量为200～5000ml,平均1995±2076ml;前后联合入路手术者术中出血量为400～6300ml,平均2400±1678ml,其9例术中行腹主动脉球囊阻断者术中出血量为2333ml。术后伤口发生并发症11例,6例不愈合,4例感染,2例皮肤坏死,1例窦道形成,均经换药及清创处理,其中2例行二期肌皮瓣转移术,均治愈。23例术前穿刺活检者22例与术后病理检查结果相符。术后早期神经功能损害加重者11例,随访期间8例完全恢复,3例部分恢复。24例获得9～198个月随访,平均45.6个月,1例恶性周围神经鞘瘤患者术后11个月死于多器官功能衰竭;局部复发9例,其中脊索瘤5例,恶性外周神经鞘瘤3例,神经鞘瘤1例,初次平均复发时间12.2个月。末次随访时,17例患者日常生活和大小便功能基本正常。结论:对于骶骨原发肿瘤术前CT引导下穿刺活检有助于明确诊断;肿瘤累及S3及以下者可采用单纯后路手术,肿瘤累及S2及以上的病例宜采用前后联合入路手术,术中腹主动脉球囊临时阻断可有效减少出血;保留双侧S2以上神经根和至少一侧S3神经根可提高患者生活质量。

原发性气管支气管肿瘤的外科治疗方法

目的探讨和总结原发性气管、支气管肿瘤的外科治疗方法。方法2000年4月至2005年2月对12例原发性气管、支气管肿瘤患者进行外科手术治疗,对患者的临床资料进行回顾性分析。经颈横切口手术1例;气管袖式切除5例;隆突加右上肺切除并隆突重建,左主支气管与气管端端吻合,右中间支气管与左主支气管端侧吻合5例;气管隆突切除重建,右主支气管与气管端端吻合,左主支气管与右主支气管端侧吻合1例。结果全组手术患者均安全度过围手术期,无手术并发症。结论原发性气管、支气管肿瘤的外科治疗应根据患者个体条件的不同,选择不同的麻醉方式、手术方式。

42例甲状旁腺肿瘤的诊断及外科治疗分析

目的:探讨甲状旁腺肿瘤的诊断及外科治疗经验。方法:回顾性分析1980年10月～2005年10月我院收治的42例甲状旁腺肿瘤患者的临床资料。结果:42例甲状旁腺肿瘤中,腺瘤31例(73.8%),癌6例(14.3%),囊肿5例(11.9%)。33例伴有甲状旁腺功能亢进(甲旁亢)症状,主要表现为骨痛和肾结石。术前B超定位和定性的诊断准确率为92.8%和61.9%,CT定位和定性诊断准确率为91.3%和65.2%。42例患者均行手术治疗,术后经1～26年随诊,40例获得临床治愈,2例复发,其中l例死亡。结论:临床医师应提高对甲状旁腺肿瘤的认识,发现骨痛、肾结石等甲旁亢症状,触及下颈部肿块,应高度怀疑甲状旁腺肿瘤的可能。常规进行血钙、血磷检测。术前影像学检查应首选B超,必要时并辅以CT检查。手术切除是最佳的治疗手段,主张术中仅行单侧甲状旁腺探查,甲状旁腺腺瘤、囊肿可仅行肿瘤切除,甲状旁腺癌应同时切除同侧甲状腺、峡叶及周围软组织,不主张行预防性颈淋巴结清除术。

心脏原发性恶性肿瘤的诊断与治疗

目的探讨心脏原发性恶性肿瘤的诊断和治疗方法,以提高诊疗水平。方法2004年4月～2008年6月,共19例心脏原发性恶性肿瘤患者在我科接受诊断及治疗,其中男11例,女8例;年龄17～64岁(40.7±12.1岁)。术前临床诊断:心脏占位性病变,原发性恶性肿瘤。在全身麻醉体外循环下完整切除肿瘤3例,部分切除1例,行同种异体心脏移植1例,开胸探查取活组织检查5例;9例(47.4%)患者失去了手术治疗的机会。结果全组无围手术期死亡。住院时间9～15d(10±7d),均顺利出院。术后发生心包积液2例,发热1例,均经对症治疗治愈。术后病理检查:平滑肌肉瘤1例,恶性间皮瘤1例,血管内皮肉瘤8例。随访14例(73.7%),随访时间1～38个月,死亡14例(73.7%),死于肿瘤复发或远处转移,失访5例(26.3%)。结论心脏原发性恶性肿瘤预后差,尽早明确诊断,尽可能完整地切除肿瘤可改善患者的生存质量。

儿童长骨骨巨细胞瘤诊断及外科治疗

[目的]研究儿童四肢长骨骨巨细胞瘤的发病,评价不同手术方式的效果.[方法]对1994年12月～2003年12月本院收治的骨巨细胞瘤患者进行统计分析,根据Enneking分级系统分级,Ⅰ～Ⅱ级采用肿瘤刮除,氯化锌烧灼残腔,双氧水浸泡和异体植骨的方法进行治疗,Ⅲ级采用瘤段切除大段异体骨移植重建,术后定期随访.[结果]在128例骨巨细胞瘤患者中,儿童患者8例发病率为6.3%.其中Ⅰ级2例,Ⅱ级5例,Ⅲ级1例,伴发病理性骨折2例.6例行肿瘤刮除植骨后骨修复完善,肢体无畸形,2例病理性骨折愈合良好;1例异体骨段移植骨愈合良好,无塌陷及骨折,但患肢短缩2.5 cm,无移植排斥;1例腓骨上端病变行腓骨小头切除,无功能障碍.术后随访2～9 a,平均5.4 a,未见肿瘤局部复发和远处肺转移.[结论]骨巨细胞瘤可以发生在儿童四肢长骨,刮除、氯化锌烧灼、双氧水浸泡和异体植骨可以达到满意效果,而瘤段切除会对儿童肢体发育产生影响.

电视胸腔镜治疗食管黏膜下肿物20年经验

目的探讨食管黏膜下肿物的临床特点、术式选择和中长期疗效。方法回顾性分析1996年9月-2016年2月20年共89例外科治疗食管黏膜下肿物的资料,分析临床资料、影像学资料、内镜资料、病理资料、治疗方式、治疗经过及术后随访资料。男57例,女32例,男∶女约为2∶1。年龄（44.1±11.0）岁。行肿瘤切除术85例（95.5%）,其中胸腔镜手术（video-assisted thoracoscopic surgery,VATS）69例（77.5%）,VATS中转开胸4例（4.5%）,直接开胸5例（5.6%）,经颈部切口5例（5.6%）,腹腔镜2例（2.2%）;行食管切除重建术3例（3.4%）;仅行活检1例（1.1%）。结果全组围手术期无死亡,无食管漏发生,1例乳糜胸,保守治疗治愈。病理诊断平滑肌瘤74例（83.1%）,胃肠道间质瘤（gastrointestinal stromal tumor,GIST）6例（6.7%）,神经纤维瘤、包涵囊肿各3例（3.4%）,血管瘤、脂肪肉瘤和原始神经外胚层肿瘤（primitive neurotodermal tumour,PNET）各1例（1.1%）。60例（67.4%）术后随访10-224个月,（72.3±47.6）月。1例高危型GIST术后24个月复发,未进一步治疗,术后60个月带瘤生存,其余5例GIST随访63-185个月,（143.6±55.4）月,未见复发。1例脂肪肉瘤术后70个月死于合并卵巢癌,其余53例无复发、死亡。结论食管黏膜下肿物是一组以良性和低度恶性为主的间质来源肿瘤,术前超声内镜检查、术中冰冻检查能帮助术者明确诊断。胸腔镜食管肿物切除术安全可行,适用于绝大部分患者,且长期效果良好,可作为治疗该病的标准术式。

275例原发性心脏肿瘤临床诊断与治疗

目的总结原发性心脏肿瘤的临床特征及治疗结果。方法回顾性分析275例原发性心脏肿瘤患者的临床资料。275例中良性肿瘤251例(91.27%,其中左房黏液瘤237例),恶性肿瘤24例(8.72%)。主要临床表现为心悸、气短,共245例,占89.09%。272例行手术治疗,其中完整切除258例,局部切除6例,8例因肿瘤无法切除仅行活检术。7例实性瘤体患者同期行二尖瓣置换术,2例同期行肺动脉瓣置换术,5例同期行经股动脉取瘤栓术。结果术前死亡2例,术中死亡3例。术后随访230例(83.63%),时间6个月～31年,死亡35例,其中良性肿瘤15例,恶性肿瘤20例,4例复发(良性1例、恶性3例),其余均恢复良好。结论原发性心脏肿瘤中左房黏液瘤最为常见,主要临床表现为心悸、气短。一经确诊应尽早手术,良性肿瘤手术效果好,恶性肿瘤预后差。