经剑突下胸腔镜切除胸廓入口处肿瘤6例  

Subxiphoid Incision Thoracoscopic Resection of 6 Cases of Thoracic Inlet Tumors

作　　者：王帅 敖永强 蒋家好 高健 林淼 丁建勇 Wang Shuai;Ao Yongqiang;Jiang Jiahao(Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China)

机构地区：[1]复旦大学附属中山医院胸外科,上海200032

出　　处：《中国微创外科杂志》2021年第10期941-944,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：复旦大学附属中山医院优秀青年计划(2021ZSYQ28)。

摘　　要：目的探讨经剑突下胸腔镜切除胸廓入口处肿瘤的可行性。方法2020年9月~2021年2月,采用经剑突下切口胸腔镜切除胸廓入口处肿瘤6例。肿瘤最大径2~4.5 cm,平均3.25 cm,无明确心脏大血管侵犯。剑突下及左右旁开约5 cm肋弓下缘三孔手术,胸骨拉钩辅助暴露视野,完整切除肿瘤组织和周围脂肪组织。结果手术均顺利完成,无围手术期死亡,无输血和中转开胸,1例因合并左上肺占位改右侧卧位经2个左侧肋间切口行左上肺叶切除术。无迟发出血、肺不张、胸腔积液、胸腔或纵隔积气、膈神经或臂丛神经损伤、重症肌无力等并发症。术后随访1~8个月,中位数4个月,无肿瘤复发。结论小样本结果显示剑突下胸腔镜切除胸廓入口处肿瘤安全、可行。Objective To explore the feasibility of thoracoscopic resection of thoracic inlet tumors via the subxiphoid incision.Methods From September 2020 to February 2021,6 cases of thoracic inlet tumors were resected by thoracoscopy through a subxiphoid incision.The maximum diameter of the tumor was 2-4.5 cm,with an average of 3.25 cm.There was no clear invasion of heart and great blood vessels.Three incisions were opened below the xiphoid process and at the lower edge of the costal arch.The sternal retractor was used to assist in exposing the visual field,and the tumor tissue and surrounding adipose tissue were completely removed.Results The operations were successfully completed,without perioperative death,blood transfusion or conversion to thoracotomy.One patient was changed to the right decubitus position due to the occupation of the left upper lung,and the left upper lobectomy was performed through two left intercostal incisions.No complications such as delayed bleeding,atelectasis,pleural effusion,pneumothorax or pneumomediastinum,phrenic nerve or brachial plexus nerve injury,and myasthenia gravis were observed.The postoperative follow-ups lasted for 1-8 months(median,4 months)and no tumor recurrence was found.ConclusionThe results of a small sample show that thoracoscopic resection of thoracic inlet tumors via the subxiphoid incision is safe and feasible.

关 键 词：胸廓入口处肿瘤 剑突下切口 胸腔镜 胸骨拉钩 

分 类 号：R73[医药卫生—肿瘤]