Objectives We report a case in which a patient who suffered from angina secondary to mediastinal irradiation and have been treated by off-pump coronary artery bypass （OPCAB） in our hospital since 3 years ago. A 34-...Objectives We report a case in which a patient who suffered from angina secondary to mediastinal irradiation and have been treated by off-pump coronary artery bypass （OPCAB） in our hospital since 3 years ago. A 34-year-old man presented with angina for 8 years after receiving radiation therapy for Hodgkin＇s lymphoma. We retrospectively reviewed all the cases of OPCAB in our hospital and followed-up data for up to 3 years post-operatively. Mediastinal irradiation is probably the cause of significant ostial stenosis of left main coronary and right coronary artery. OPCAB grafting was performed on this patient 3 years ago. His angina disappeared after operation, and he recovered well during follow-up. Conclusions Patients with malignancies who have received mediastinal irradiation should be carefully followed up and routinely screened for the premature development of coronary artery disease. OPCAB may be an appropriate treatment for coronary artery disease caused by mediastinal irradiation.展开更多
文摘Objectives We report a case in which a patient who suffered from angina secondary to mediastinal irradiation and have been treated by off-pump coronary artery bypass （OPCAB） in our hospital since 3 years ago. A 34-year-old man presented with angina for 8 years after receiving radiation therapy for Hodgkin＇s lymphoma. We retrospectively reviewed all the cases of OPCAB in our hospital and followed-up data for up to 3 years post-operatively. Mediastinal irradiation is probably the cause of significant ostial stenosis of left main coronary and right coronary artery. OPCAB grafting was performed on this patient 3 years ago. His angina disappeared after operation, and he recovered well during follow-up. Conclusions Patients with malignancies who have received mediastinal irradiation should be carefully followed up and routinely screened for the premature development of coronary artery disease. OPCAB may be an appropriate treatment for coronary artery disease caused by mediastinal irradiation.
文摘目的:探索多学科团队(multidisciplinary team,MDT)诊疗模式对纵隔疾病的治疗策略。方法:回顾性分析在2020年1—12月复旦大学附属中山医院接受纵隔MDT讨论的纵隔疾病患者的临床资料,并与2019年未进行MDT讨论的胸腺肿瘤患者的临床资料进行对比。结果:共为166例患者进行185次MDT讨论,涉及的病种包括112例胸腺上皮肿瘤、12例淋巴瘤、21例生殖源性肿瘤、6例后纵隔神经源性肿瘤,、12例其他肿瘤、3例非肿瘤性疾病。35例首选手术治疗,35例在放化疗后进行手术治疗。与既往未接受纵隔MDT讨论的胸腺肿瘤患者的临床资料进行比较,接受纵隔MDT讨论的胸腺肿瘤患者的中位诊断治疗间隔时间缩短(13 vs 7 d),接受手术治疗的比例提高(35.8%vs 45.7%),手术完全切除的比例提高(76.5%vs 79.1%),术后平均住院时间缩短(9 vs 7 d)。结论:MDT讨论对于复杂纵隔疾病的治疗具有潜在优势,能够为患者制定安全合理的治疗策略。
