电视胸腔镜治疗后纵隔神经源性肿瘤  

Video-assisted thoracoscopic surgery of posterior mediastinal neurogenic tumor

作　　者：罗爱国[1] 轩永波[1] 唐开维[1] 展宇飞 左艳[1] 潘禹辰[1] 

机构地区：[1]解放军第181医院心胸外科,广西桂林541002

出　　处：《临床军医杂志》2015年第1期3-6,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨电视胸腔镜治疗后纵隔神经源性肿瘤的疗效及操作特点。方法选择我院2006年5月—2012年5月收治的后纵隔神经源性肿瘤52例作为研究对象,均在电视胸腔镜下切除肿瘤,对无法在电视胸腔镜下手术者中转开胸。结果 52例患者中49例顺利在胸腔镜下完成手术,3例中转开胸,无死亡和复发病例;手术时间平均为(112.3±38.4)min,术中出血量平均为(229.4±105.3)ml,术后胸腔闭式引流平均时间为(2.9±0.9)d,术后住院时间平均为(6.2±2.7)d;术后病理报告神经鞘瘤24例,神经纤维瘤20例,神经节细胞瘤8例;术后SF-36各维度评分均明显高于治疗前(P<0.05);术后发生一过性Honor综合征2例,皮下气肿2例,肺不张1例;肿瘤直径<6.00 cm组的患者其手术时间、术中出血量及住院时间等均明显优于≥6.00 cm组;<6.00 cm组患者中转开胸率为0%,低于≥6.00 cm组患者的中转开胸率16.7%,但差异无统计学意义(P>0.05)。结论电视胸腔镜治疗后纵隔神经源性肿瘤具有微创、切口美观、损伤恢复快等优点,是一种安全有效的治疗方式,可作为后纵隔神经源性肿瘤的首选术式。Objective To investigate the curative effect and operation features of video-assisted thoracoscopic surgery （VATS） of posterior mediastinal neurogenic tumor. Methods Fifty-two cases of posterior mediastinal neurogenie tumor admitted to our hospital and treated by VATS from May 2006 to May 2012 were selected as subjects. Results Thoracoseopic operation was successfully completed in 49 eases and the other 3 cases were converted to open operation, without any death and recurrence. The mean operation time was （ 112.3 ±38.4） rain, the average intraoperative blood loss was （ 229.4 ± 105.3 ） ml, and the average postoperative thoracic c]osed drainage time was （2.9 ± 0.9） d. SF-36 scores were significantly higher after treatment than before treatment （P 〈 0.05）. There were 2 cases of Honor syndrome, 2 cases of subcutaneous emphysema, and 1 case of atelectasis after operation. The operation time, bleeding volume and hospitalization time were ]ess in the patients with tumor diameter 〈 6.00 cm than those with 6.00 cm. Rate of conversion to open surgery was 0% in the patients with tumor diameter 〈 6.00 cm and 16.7% in those ≥6.00 cm, between which the difference was not statistically significant （ P 〉 0.05 ）. Conclusion Safe and effective VATS applied to mediastinal neurogenic tumor has the advantage of minimally invasive incision, less injury and quick recovery, and may be the first treatment of choice for posterior mediastinal neurogenie tumor.

关 键 词：纵隔肿瘤 电视胸腔镜 神经源性肿瘤 

分 类 号：R734.5[医药卫生—肿瘤]