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目的探讨体外循环技术在腹部软组织肿瘤手术中的应用价值。方法回顾性分析2011年4月至2015年12月期间于复旦大学附属中山医院接受体外循环技术辅助下的腹部软组织肿瘤切除的9例患者的临床资料。结果 9例患者均完整切除肿瘤,无围手术期死亡。6例行全体外循环,3例行部分体外循环。建立体外循环的动脉灌注采用升主动脉途径6例,股动脉途径3例;静脉引流采用下腔静脉途径2例,上腔静脉途径6例,股静脉途径2例,颈静脉途径3例。7例为静脉平滑肌瘤病,1例为小圆细胞恶性肿瘤,1例为平滑肌肉瘤。术后发生十二指肠瘘1例,经保守治疗痊愈;1例发生下腔静脉血栓形成,给予放置下腔静脉滤器处理。9例患者均获随访,随访时间为1~57个月,中位数为4个月。随访期间所有患者均存活,无复发转移病例。结论体外循环技术的应用,为一些复杂的腹部软组织肿瘤病例提供了手术完整切除的可能。
Objective To explore the value of extracorporeal circulation in the surgical treatment of abdominal soft tissue tumors. Methods The clinical data of 9 patients undergoing abdominal soft tissue tumor resection assisted by cardiopulmonary bypass at Zhongshan Hospital Affiliated to Fudan University from April 2011 to December 2015 were retrospectively analyzed. Results Nine patients underwent complete resection of the tumor without perioperative death. 6 routine external circulation, 3 routine partial cardiopulmonary bypass. The establishment of cardiopulmonary bypass arterial perfusion ascending aorta pathway in 6 cases, femoral artery pathway in 3 cases; venous drainage by inferior vena cava in 2 cases, superior vena cava in 6 cases, femoral vein in 2 cases, jugular vein in 3 cases. 7 cases of veno-leiomyoma, 1 case of small cell malignant tumor, 1 case of leiomyosarcoma. One case of duodenal fistula occurred after conservative treatment, one case had IVC thrombosis, and the inferior vena cava filter was placed. All 9 patients were followed up for 1 to 57 months with a median of 4 months. All patients survived during follow-up, with no recurrence or metastasis. Conclusion The application of cardiopulmonary bypass technology provides the possibility of complete resection for some complex cases of abdominal soft tissue tumors.