Effects of one-stage and two-stage surgery on intracardiac leiomyomatosis

Wei Min; Qiu Yue; Huang Yuguang

doi:10.3760/j.issn.1673-4777.2019.05.011

Abstract：Objective To compare the clinical effects between one-stage and two-stage surgery of intracardiac leiomyomatosis. Methods Twenty-five cases of intracardiac leiomyomatosis in Peking Union Medical College Hospital,Chinese Academy of Medical Sciences between January 2002 and December 2016 were selected. According to the choice of surgical methods,the patients were divided into one-stage group(n = 10) and two-stage group(n = 15). General information,medical history,clinical manifestations,surgical and anesthetic data,postoperative follow-up data,recurrence rate and complication rate were analyzed. Results There was no significant difference of general information,medical history and clinical manifestations between groups(all P > 0.05). Amount of blood loss in one-stage group was significantly more than that in two-stage group[(5 621 ± 3 208) ml vs (3 144 ± 2 059) ml, t = 2.360]; operative time,anesthesia time,length of hospital stay in one-stage group were significantly shorter than those in two-stage group [(528 ± 180) min vs (618 ± 270) min,(600 ± 180) min vs (732 ± 288) min, (28 ± 8) d vs (48 ± 16) d](t = 2.757,2.769, -0.269; all P < 0.05). There was no significant difference of cardiopulmonary bypass time,aortic cross-clamping time,deep hypothermic circulatory arrest time,intubation time,intensive care unit stay time,autologous blood transfusion rate and allogeneic blood transfusion rate between groups(all P > 0.05). Follow-up time,recurrence and complications in one-stage group and two-stage group were (22 ± 10) months vs (21 ± 9) months,1 case vs 3 cases,2 cases(poor wound healing) vs 3 cases(hydronephrosis, infection,pelvic infection); there was no significant difference between groups (P = 0.851,0.626,0.050). Conclusions One-stage surgery and two-stage surgery show similar effect on intracardiac leiomyomatosis. One-stage surgery can reduce operative time,anesthesia time and length of hospital stay.