摘要
目的探讨后纵隔神经源性肿瘤微创手术治疗的方法和价值。方法 1993年5月～2009年3月,经微创手术切除42例后纵隔良性神经源性肿瘤。胸腔镜切除29例,其中16例加小切口辅助;脊柱旁小切口胸膜外切除10例;哑铃形肿瘤3例,均后正中切口切除椎管内肿瘤,1例胸腔镜切除胸内肿瘤,2例脊柱旁小切口胸膜外切除。结果 42例均完整切除肿瘤,无中转开胸。无并发症。病理诊断神经鞘瘤27例,神经纤维瘤7例,神经节细胞瘤8例。34例随访6个月～14年,其中<3年16例,3～5年13例,>5年5例。无局部复发。结论微创手术切除后纵隔良性神经源性肿瘤安全、可靠、创伤小。胸腔镜手术为首选治疗方法。对有胸膜粘连或肿瘤长入椎间孔者,应选择脊柱旁小切口胸膜外切除方法 。
Objective To evaluate the efficacy and value of minimally invasive operation in the treatment of posterior mediastinal benign neurogenic tumors. Methods From May 1993 to Match 2009, 42 patients with posterior mediastinal benign neurogenic tumor received minimally invasive surgery in our hospital. Of the patients, 29 cases received thoracoscopy （with auxiliary incision in 16 of the cases）, paravertebral incision for extrapleural resection was made in 10 cases; 3 cases with dumbbell-shaped postmediastinal tumor were treated by intraspinal resection through a posterior medial incision （the tumor was removed by thoracoscopy in one patient, and via paravertebral incision in two cases）. Results The operations were successfully completed in all of the 42 cases without conversion to open surgery nor complications. Postoperative pathological examination showed 27 cases of neurilemmoma, 7 cases of neurofibroma, and 8 cases of paraganglioma. Follow-up was achieved in 34 cases for 6 months to 14 years （3 years in 16 cases, 3-5 years in 13 cases, and 5 years in 5 cases）. No local recurrence was detected during the period. ConclusionsMinimally invasive surgery is safe and effective for posterior mediastinal benign neurogenic tumors. Thoracoscopy can be the first choice for the operation. For patients with pleural adhesion or tumors invading the intervertebral foramen, paravertebral incision for extrapleural resection shall be used.
出处
《中国微创外科杂志》
CSCD
2010年第6期488-489,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
纵隔
神经源性肿瘤
胸腔镜
微创手术
Mediastinum
Neurogenic tumor
Thoracoscopy
Minimally invasive operation
