摘要
目的 探讨胸腔镜在纵隔肿瘤诊断和治疗方面的应用。 方法 1995年 6月～ 2 0 0 2年 12月对 34例纵隔肿瘤病人行胸腔镜手术切除。男性 9例 ,女性 2 5例。年龄 16岁～ 74岁 ,平均 4 3 9岁。胸腺瘤 14例 (良性胸腺瘤 9例 ,恶性 5例 ) ,神经源性肿瘤 6例 ,支气管源性囊肿 5例 ,畸胎类肿瘤 4例 ,心包囊肿 2例 ,转移癌、淋巴瘤、蔓状血管瘤各 1例。肿瘤最大径3 5cm～ 6cm ,平均 4 5cm。全麻双腔气管插管 ,单侧肺通气 ,健侧卧位 ,胸腔镜trocar位于腋中线 6或 7肋间 ,2个操作trocar根据肿瘤位置而定。 结果 34例纵隔肿瘤中 ,2 5例完成胸腔镜肿瘤切除 ,9例小切口辅助完成。 3例仅行肿瘤活检。术后恢复良好 ,无严重并发症 ,无死亡。 结论 纵隔良性肿瘤 ,特别是中、后纵隔肿瘤 ,是胸腔镜手术的最佳适应证。
Objective To explore the application of video-assisted thoracic surgery (VATS) in the diagnosis and treatment of mediastinal tumors. Methods Thirty-four patients with mediastinal tumors underwent VATS from June 1995 to December 2002. The patients comprised 9 men and 25 women, with a mean age 43 9 years (16～74 years). Entered into the study there were 14 cases of thymoma (9 benign thymomas and 5 malignant), 6 cases of neurogenic benign tumors, 5 bronchogenic cysts, 4 teratomas, 2 pericardial cysts and 3 other conditions (metastatic carcinoma, lymphoma and hemangioma racemosum, respectively). Maximum diameter of the tumors ranged 3 5 cm to 6 cm, mean 4 5 cm. Operations were performed under general anesthesia, double lumen endotracheal tube placement and single lung ventilation. The patients were maintained in the lateral decubitus position. Camera port was placed at the sixth or the seventh intercostals space on the midaxillary line. Sites of the other two ports depended upon the location of the tumors. Results Out of the 34 patients with mediastinal tumors, 25 patients underwent tumor removal by VATS alone and 6 patients received VATS combined with mini-thoracotomy, while the remaining 3 patients only underwent biopsy by VATS. Postoperatively, all patients recovered uneventfully, without severe complications or mortality. Conclusions VATS is the first choice for benign mediastinal tumors, typically those in the middle and posterior mediastinum.
出处
《中国微创外科杂志》
CSCD
2003年第3期222-223,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
胸腔镜手术
纵隔肿瘤
Videothoracoscopy
Mediastinal tumor
