113例纵隔畸胎瘤的外科治疗  

Surgical management of mediastinai teratoma： report of 113 cases

作　　者：谢冬[1] 包敏伟[1] 谢惠康[1] 温宗梅[1] 郑卉[1] 姜超[1] 黄威[1] 杨洋[1] 宋楠[1] 段亮[1] 王海峰[1] 武春燕[1] 朱余明[1] 费苛[1] 陈昶[1] 姜格宁[1] 

机构地区：[1]同济大学附属上海市肺科医院胸外科,200433

出　　处：《中华胸心血管外科杂志》2016年第3期132-135,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：上海市市级医院新兴前沿技术联合攻关项目，上海市卫生局青年科研项目，上海市卫生系统重要疾病联合攻关项目，2015年上海市浦江人才计划(15PJD034)Shanghai Hospital Development Center Grant，Youths of Shanghai Municipal Health Bureau，Shanghai Municipal Health Bureau United Research Projects for Vital Disease，Shanghai Pujiang Program

摘　　要：目的总结纵隔畸胎瘤的外科诊治经验。方法1980年1月至2013年12月，手术治疗纵隔畸胎瘤113例，男48例，女65例，平均年龄（32．6±7．3）岁。后外侧切口55例，胸骨正中切口22例，胸骨T形切口6例，前外侧切口15例，胸腔镜13例，颈胸联合切口2例；单纯肿瘤切除67例，肿瘤切除合并肺切除41例（肺叶切除8例，肺楔形切除33例，心包部分切除21例），无名静脉成形术1例，不全切除2例，肿瘤活检2例。结果平均手术（167．5±46．8）min，平均失血量（271±105）ml，平均术后住院（8．6±3．5）天。围手术期死亡1例，并发症9例（8．0％）。随访96例（85．0％），平均65．4个月。6例恶性畸胎瘤死于复发转移，其他病例无复发转移。结论手术切除是治疗纵隔畸胎瘤的有效措施，切口可选择经胸腔镜、侧胸切口或胸骨正中切口径路。Objective To summarize our experience in patients with mediastinal teratoma managed by surgical interven- tion. Methods From January 1980 to December 2013, 113 patients（48 males and 65 females） were diagnosed with mediasti- nal teratoma and underwent surgical treatment at our hospital. Median age was（32.6 ± 7.3 ） years. Seventy-seven patients un- derwent operation for a variety of symptoms, and 36 patients for the abnormal roentgenograms. The locations of mediastinal tera- toma were 57 cases in the left anterior mediastinum, 45 cases in the right anterior mediastinum, 9 cases in the chest and 2 cases extension from mediastinum to neck. Thoracic computerized tomography was performed in 95 patients. CT features of cystic ter- aroma were cystic mass with fluid density. CT features of solid teratoma were soft-tissue mass with mixed densities. The other CT features included ascus in cyst, fat density, and calcification. Preoperative diagnosis for the mediastinal teratoma was made in 58 cases（51.3% ）. The operation was via posterior lateral thoractomy in 55 cases, video-assisted thoracoscopic surgery （VATS） in 13 cases, median sternotomy in 22 cases, median sternotomy with anterior lateral thoractomy in 6 cases, anterior lateral thoractomy in 15 cases, and cervical incision with median sternotomy in 2 case. The operation was simple resection of tumor in 67 cases, teratoma resection with pulmonary resection in 41 cases, teratoma resection with partial resection of innomi- nate vein in 1 case, debulking resection in 2 case and biospy in 2 cases for the immature teratoma. Results There was one postoperative death, and the operative complication occurred in 9 patients（ 8.0% ）. The average operation time was（ 167.5 ± 46.8 ） rain, and the average blood loss was （271 ± 105 ） ml. The postoperative hospital stay was （8.6 ±3.5 ） days on average. Follow-up was completed in 96 patients（85.0% ） ranged from 12 to 108 months（ average, 65.4 months）. Six patients with im- mature teratoma were

关 键 词：纵隔肿瘤 畸胎瘤 诊断 胸外科手术 

分 类 号：R734.5[医药卫生—肿瘤]