ⅣA期胸腺瘤的外科治疗——附7例报告  

Surgical approach for stage ⅣA thymoma-- A clinical experience with 7 cases

作　　者：林钢[1] 李简[1] 刘海波[1] 刘冰[1] 

机构地区：[1]北京大学第一医院胸外科,北京100034

出　　处：《解放军医学杂志》2016年第1期50-53,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨外科手术治疗ⅣA期胸腺瘤的安全性及远期疗效。方法回顾性收集并分析北京大学第一医院胸外科2007年1月-2014年12月收治的7例ⅣA期胸腺瘤患者的临床资料。结果 7例ⅣA期胸腺瘤患者中男4例,女3例,中位年龄38（27~57）岁,左侧病变4例,右侧病变3例。5例为初治病例,2例为术后复发患者。手术时间为10.4±2.8h,中位出血量1000（300~8200）ml,术后中位住院时间14（10~54）d。无围术期死亡,3例（42.9%）术后出现严重并发症,5例（71.4%）出现轻微并发症。清扫淋巴结4~47个,平均12个,1例发现转移。中位随访时间24（5~81）个月,6例存活,肿瘤无复发,1例患者术后81个月时死于肿瘤复发。结论ⅣA期胸腺瘤目前推荐的治疗方式是包括手术和放化疗在内的综合治疗。对于经过选择的患者手术治疗是安全有效的,患者可获得长期生存。应根据疾病进展程度和患者状况选择合适的手术方式。Objective To discuss the safety and the outcome of surgical treatment for patient w ith ⅣA thymoma. Methods Seven patients with stage ⅣA thymoma were treated surgically between Jan. 2007 and Dec. 2014. Clinical data and follow-up information were collected and analyzed. Results The median age of the patients was 38 years old（range 27-57 years）. There were four male patients. Tumor was located in the left thoracic cavity in four patients. In 5 patients it was synchronous primar y thymoma（Stage ⅣA）, and in 2 patients it was a recurrence after initial thymoma resection. Mean operation time was 10.4±2.8 hours, median blood loss was 1000（300-8200）ml, median postoperative stay in hospital was 14（10-54） days. There was no postoperative death. Major postoperative complication occurred in 3 patients（42.9%）. Minor postoperative complication occurred in 5 patients（71.4%）. A mean of twelve lymph nodes（range 4-47） were resected, and lymph node metastasis was found in one patient. Median follow-up time was 2 4（5-81） months, and all patients except one survived without evidence of recurrence. One patient died of recurrence of tumor 81 months after surger y. Conclusions The recommended therapy for ⅣA stage thymoma is multidisciplinary, including radiation, chemotherapy, and surgery. In selected patient with stage ⅣA thymoma, surgical resection is a safe and effective procedure with a long survival time. The choice of resection should conform to the extent of disease and patient＇s condition.

关 键 词：胸腺瘤 转移瘤切除术 肺切除术 

分 类 号：R736.3[医药卫生—肿瘤]