单拉钩胸骨悬吊法在前纵隔肿瘤患者中的应用  

Application of single-pull hook sternum suspension in patients with anterior mediastinum tumor

作　　者：刘博豪 王泓懿 范坤 赵恒 李益行 陶润仪 王芝馀 温小鹏[1] 付军科[1] 张佳[1] 张广健[1] Liu Bohao;Wang Hongyi;Fan Kun;Zhao Heng;Li Yixing;Tao Runyi;Wang Zhiyu;Wen Xiaopeng;Fu Junke;Zhang Jia;Zhang Guangjian(Department of Thoracic Surgery,First Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710061,China;Health Science Center,Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院胸外科,西安710061 [2]西安交通大学医学部,西安710061

出　　处：《中华胸部外科电子杂志》2021年第1期6-11,共6页CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition

基　　金：陕西省高校联合一般项目(2020GXLH-Y-012)。

摘　　要：目的评估拉钩胸骨悬吊法剑突下前纵隔肿瘤切除的临床效果,探讨其应用优势。方法回顾性分析西安交通大学第一附属医院2019年1月1日至2020年9月30日收治的14例前纵隔肿瘤患者的临床资料,术前CT明确其肿瘤部位和大小,实施单悬吊辅助电视胸腔镜外科手术(VATS)经剑突下纵隔切除术,观察统计手术基本情况及术后恢复情况。结果 14例患者均顺利完成手术。其中女6例,男性8人,年龄17~74(46.35±9.28)岁,肿块最大径(5.03±2.32)cm。14例患者在单拉钩胸骨悬吊辅助下行胸腔镜手术。手术时长(124.32±35.71)min,手术出血量(43.27±20.31)mL,术后住院时间(5.32±1.34)d,术后胸腔引流管留置时间(1.84±0.82)d,日引流量(230.45±70.35)mL,无转入开胸治疗,无院内死亡,无术后并发症,术后随访3~6个月无肿瘤转移。结论在前纵隔肿瘤临床治疗中,单拉悬吊拉钩辅助的胸腔镜手术治疗方法具有术中视野清晰、创伤小、治疗效果显著、手术操作便捷的优势,术后无悬吊相关并发症,手术方法安全有效。Objective To evaluate the clinical effect of anterior mediastinal tumor resection under xiphoid process by sternal suspension with retractor and to discuss its application advantages.Methods A retrospective review of 14 patients with anterior mediastinal tumors in the First Affiliated Hospital of Xi’an Jiaotong University between January 2019 to September 2020 was performed.Preoperative CT confirmed the location and size of the tumor,and single-suspended-assisted video-assisted thoracoscopic surgery resection through the inferior mediastinum of xiphoid process was performed.The basic operation conditions and postoperative recovery were observed and counted.Results All the 14 patients successfully completed the surgery.There were 6 females(42.86%)and 8 males,aged 17–74(46.35±9.28)years old.The maximum diameter of the mass was(5.03±2.32)cm.All the 14 patients underwent video-assisted thoracoscopic surgery under the assistance of sternal suspension with a single retractor.The operation duration was(124.32±35.71)min,the operation bleeding volume was(43.27±20.31)mL,the postoperative hospital stay was(5.32±1.34)d,the postoperative indwelling time of thoracic drainage tube was(1.84±0.82)d,and the average daily drainage volume was(230.45±70.35)mL.No patient was transferred to thoracotomy for treatment,and there was no hospital death or postoperative complications.No tumor metastasis was found after follow-up for 3 to 6 months.Conclusion In the clinical treatment of anterior mediastinal tumors,the video-assisted thoracoscopic surgery assisted by single-pull suspension retractor has the advantages of clear field of view during the operation,small trauma,significant therapeutic effect,and convenient operation.There is no suspension-related complication after operation,and the surgical method is safe and effective.

关 键 词：前纵隔肿瘤 拉钩 电视辅助胸腔镜外科手术 剑突 

分 类 号：R734.5[医药卫生—肿瘤]