双孔胸腔镜联合后正中切口治疗后纵隔哑铃形神经源性肿瘤  

Double-hole thoracoscopic surgery via posterior midline approach for dumbbell neurogenic tumors of the posterior mediastinum

作　　者：李志华[1] 麻成方[1] 李绍鹏[1] 汪礼旭[1] 洪琼川[1] 

机构地区：[1]深圳市龙岗中心医院心胸外科,518116

出　　处：《中华神经医学杂志》2015年第8期846-849,共4页Chinese Journal of Neuromedicine

摘　　要：目的总结双孔胸腔镜联合后正中切口治疗后纵隔哑铃形神经源性肿瘤的疗效。方法深圳市龙岗中心医院心胸外科自2003年2月至2013年5月共收治后纵隔哑铃形神经源性肿瘤患者11例，其中采用传统后外侧切口进胸联合后正中切口切除肿瘤7例（对照组），采用胸腔镜联合后正中切口切除肿瘤4例（治疗组），回顾性分析患者的临床资料和疗效。结果全部患者均顺利完成手术，治疗组患者未增加辅助切口或中转开胸，术后恢复顺利，未发生神经功能障碍和脑脊液外漏等严重并发症。与对照组比较，治疗组患者手术时间较长，但术中出血量较少，术后胸腔引流时间及术后住院时间较短。术后病理显示神经纤维瘤8例，神经鞘瘤3例。术后随访12～36个月，患者没有发生严重的神经功能障碍或肿瘤复发。结论用双孔胸腔镜联合后正中切口切除后纵隔哑铃形神经源性肿瘤安全、有效、微创。Objective To study the operation approach and operation method for giant dumbbell neurogenic tumors of the posterior mediastinum, and summarize the experience ofthoracoscopic surgery via posterior midline approach in tumor resection. Methods The clinical data of 11 patients with posterior mediastinum dumbbell tumor, admitted to our hospital from February 2003 to May 2013, were analyzed retrospectively. Traditional posterolateral incision combined with thoracic tumor resection was performed in the 7 patients of control group; and thoracic laminectomy combined with intraspinal tumor mass resection was performed in the 4 patients of treatment group. Results The operation went smoothly. Patients in the treatment group accepted no auxiliary incision or conversion to thoracotomy, without occurrence of dysneuria and cerebrospinal fluid leakage and other serious complications. As compared with the control group, the treatment group had smaller volume of bleeding, shorter chest drainage time and hospital stays, and longer operation time. Postoperative pathology implied 8 neurofibromas and 3 schwannomas. No dysneuria or recurrence was found during the follow-up of 12-36 months. Conclusion Double-hole thoracoscopic surgery via posterior midline approach is a safe, effective, minimally invasive method in the treatment of dumbbell neurogenic tumors of the posterior mediastinum.

关 键 词：椎管 后纵隔神经源性肿瘤 胸腔镜手术 

分 类 号：R734.5[医药卫生—肿瘤]