维普中文期刊产品整合服务

Diagnosis and surgical treatment of intraveneous leiomyomatosis extending into the heart:two cases report and review of the literature

查看全文 作　　者：Xiaowei Wang Lin Zhang Yijiang Chen Shijiang Zhang Jianwei Qin Yanhu Wu Jinhua [1]Luo 高影响力作者 机构地区：[1]Department of Thoracic & Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China高影响力机构 出　　处：《Journal of Nanjing Medical University》索引2009年第23卷第5期,共6页高影响力期刊 基　　金：supported by a grant:the'QingLan'project;the Department of Education of Jiangsu province,No.(JX10210540 /DG216G15020) 摘　　要：Objective:To investigate the clinical characteristics,diagnosis and surgical treatment of intravenous leiomyomatosis(IVL),and outline the differences between Chinese and overseas cases.Methods:Clinical data of two IVL cases,treated in our hospital,were analyzed retrospectively and the related literature was also reviewed.The data of preoperative diagnostic rate,surgical procedures,and postoperative recurrence between patients in China and other countries were compared.Results:The first stage operation was performed successfully in 2 patients.However,they refused subsequent therapies,including a second stage operation to excise the remnants of the tumor,uterus,bilateral oviducts and ovaries,and anti-estrogen therapy.Both suffered from IVL recurrence,one at 6-month and the other at 9-month,and died at 16-month and 12-month respectively after the first stage surgery.Worldwide reports of 110 IVL cases were reviewed,which included 28 cases in China and 82 cases in other countries.In the majority of the Chinese patients,tumors only extended into the right atrium rather than the right ventricle(RA 22 cases vs RV 4 cases).However,among the overseas patients,the rate of extension into the right atrium was similar to that of extension into the right ventricle(RA 41 cases vs RV 38 cases).The rate of hysterectomies was not significantly different between Chinese and overseas patients(67.86% vs 55.9%,P=0.278).The rate of correct preoperative diagnosis in the Chinese patients was significantly lower than that in the overseas patients(32.14% vs 80%,P=0.000002),as well as the rate of complete excision of the tumor(22.7% vs 75.5%,P=0.000001).The proportion of patients who undergoing a single-stage or a two-stage operation was similar in Chinese and overseas patients.The recurrence rate was significantly higher in the Chinese patients than in the overseas patients(36.8% vs 9.1%,P=0.0055),and the patients with tumor recurrence were partial tumor excision patients.Conclusion:The possibility of IVL should be considered if echocardiography in female patients demonstrates a tumor in the right heart and a mass in the inferior vena cava(IVC).Further imaging should be performed to confirm the diagnosis.The correct diagnosis and accurate preoperative delineation of tumor extension are essential for an optimal surgical outcome.The key point in IVL treatment is the complete excision of tumors(single-stage or two-stage surgical procedure). 关 键 词：诊断 外科手术 治疗 心脏疾病
相关文献

参考文献(10)

引证文献(5)

网站首页 | 关于我们 | 联系我们 | 产品服务 | 客服中心 | 广告服务 | 版权声明 | 网站联盟 | 友情链接 | 售卡网点

版权所有© 渝B2-20050021-1　渝公网安备 50019002500403号　违法和不良信息举报中心

互联网出版许可证 新出网证(渝)字10号 全国400电话 - 免长途话费