经剑突下胸腔镜技术在前纵隔肿瘤外科治疗中的应用  

Clinical application of subxyphoid approach video-assisted thoracoscopic surgery for treatment of anterior mediastinal tumors

作　　者：张勇 王哲[2] 张广健[2] 张勇[2] 贾卓奇[2] 李新举[2] 付军科[2] 吴齐飞[2] 

机构地区：[1]宝鸡市中医院胸外科,陕西宝鸡721000 [2]西安交通大学医学院第一附属医院胸外科,陕西西安710061

出　　处：《现代肿瘤医学》2017年第11期1731-1733,共3页Journal of Modern Oncology

基　　金：陕西省社会发展科技攻关计划项目(编号:2015SF211)

摘　　要：目的:探讨经剑突下胸腔镜技术在前纵隔肿瘤外科治疗中的临床应用价值。方法:回顾性分析2015年11月至2016年10月我院胸外科采用经剑突下胸腔镜手术治疗的13例前纵隔肿瘤患者临床资料,其中男性7例、女性6例。平均年龄49.3岁(31~61岁)。病理类型为单纯胸腺瘤3例,胸腺瘤合并重症肌无力4例,支气管囊肿2例,胸腺囊肿3例,海绵状血管瘤1例。结果:所有患者均采用经剑突下胸腔镜手术完成了前纵隔肿瘤的切除,术中操作时间107 min(75~150 min),术中出血量60 ml(30~180 ml),术中均无严重并发症发生,术后胸腔引流管留置时间1.9天(0~5天),术后住院时间4.7天(2~6天),13例患者均术后随访,未见明显手术相关并发症。结论:经剑突下胸腔镜手术治疗前纵隔肿瘤安全可行。Objective To evaluate the therapeutic methods and value of subxyphoid approach video - assisted tho-racoscopic surgery for treatment of anterior mediastinal tumors. Methods: The clinical data of 13 cases,with anterior mediastinal tumors underwent subxyphoid approach video - assisted thoracoscopic surgery from November 2015 to Oc-tober 2016 were analyzed retrospectively. Among the thirteen cases,threr were 1 case of male and 6 cases of female, and the average age of these cases was 49. 3 years old (31 -61 years old) . Pathological examination showed thymoma in 3 cases,thymoma with myasthenia gravis in 4 cases,bronchogenic cyst in 2 cases,thymus cyst in 3 cases,cavernous hemangioma in 1 case. Results: The complete resections were successfully performed in all 13 cases with no complica-tion and death in the study. Average operation time was 107 min (75 -150 min), and average bleeding was 60 ml (30 -180 ml) . Average thoracic cavity drainage time was 1.9 days ( 0 -5 days ) and average hospitalization time was 4. 7 days ( 2 -6 days). Thirteen cases were followed up for 1 month to 1 year and there were no complications. Conclusion : Subxyphoid approach VATS is safe and feasible in treatment of anterior mediastinal tumors.

关 键 词：前纵隔肿瘤 胸腔镜 经剑突下手术 

分 类 号：R734.5[医药卫生—肿瘤]