经胸腔镜微创外科与传统手术治疗原发性纵隔肿瘤的对比分析  

Resection of primary mediastinal tumors by video-assisted thoracoscopic surgery versus conventional open surgery

作　　者：高立平[1] 

机构地区：[1]河北医科大学第四医院胸外科,河北石家庄050011

出　　处：《实用肿瘤杂志》2017年第1期70-73,共4页Journal of Practical Oncology

摘　　要：目的比较胸腔镜微创外科与传统手术治疗原发性纵隔肿瘤的临床价值。方法对比性分析214例经胸腔镜微创外科或传统手术治疗的原发性纵隔肿瘤患者的临床资料。所有患者中,胸腺肿瘤108例,神经源性肿瘤29例,生殖细胞肿瘤26例,纵隔囊肿20例,间叶源性肿瘤15例,胸内异位组织肿瘤11例,淋巴瘤2例,透明血管型Castleman病2例,膈肌恶性纤维性肿瘤1例。结果经胸腔镜术式组(n=84)与传统术式组(n=130)的性别、年龄和手术时间比较差异均无统计学意义(均P>0.05),而胸腔引流量[(677.68±102.26)m L vs(723.69±124.48)m L,P=0.005]和肿瘤最大径[(5.35±1.75)cm vs(8.61±3.91)cm,P=0.000]比较差异均具有统计学意义。结论原发性纵隔肿瘤经胸腔镜切除是重要可行的手术方式,对于体积较大或外侵状态复杂者传统开式手术更为可取。Objective To compare the clinical application of video-assisted thoracoscopic surgery with conventional open surgery in treatment of primary mediastinal tumors. Methods The clinical data of 214 patients with primary mediasti- nal tumors were analyzed, including 108 cases of thymic tumors, 29 cases of neurogenic tumors, 26 cases of germ cell tumors, 20 cases of bronchogenic cysts, 15 eases of mesenchymal tumors, 11 cases of intrathoracic tumors of ectopic tis- sue, 2 cases of lymphoma, 2 cases of Castleman＇s disease and 1 case of malignant fibrous tumor of diaphragm. Among 214 cases, 84 underwent video-assisted thoraeoscopic surgery （VATS） and 130 cases underwent conventional open surgery. Results There were no significant differences in age, gender and operation time between two groups （ all P 〉 0.05 ） , while the volume of postoperative chest drainage in VAST group was less [ （677.68 ± 102.26） mL vs （ 723.69 ± 124.48 ） mL, P = 0.005 ] and tumor length [ （5.35 ± 1.75 ） cm vs （8.61 ± 3.91 ） cm, P = 0. 000 ] was shorter than that of conventional group. Conclusion VATS is feasible for primary mediastinal tumors, however, traditional open surgical resection is preferred when the primary mediastinal tumors have large size or complicated invasion.

关 键 词：纵隔肿瘤/外科学 胸腔镜 对比研究 

分 类 号：R734.5[医药卫生—肿瘤] R730.56[医药卫生—临床医学]