电视胸腔镜手术治疗前纵隔肿瘤和囊肿103例

目的探讨电视胸腔镜手术治疗前纵隔肿瘤和囊肿的方法和价值。方法回顾分析1994年7月—2010年7月完全胸腔镜下或胸腔镜辅助下小切口切除前纵隔肿瘤和囊肿103例临床资料。其中完全胸腔镜切除66例,胸腔镜辅助小切口下切除37例。结果 103例均顺利完成手术,无并发症。手术时间平均(80±15)min。术中出血平均(100±35)ml。术后留置胸腔闭式引流平均(3.5±0.5)d。术后住院平均(7±0.8)d。术后病理诊断:纵隔畸胎瘤17例,胸腺瘤34例,胸腺增生6例,支气管囊肿11例,胸腺囊肿15例,心包囊肿4例,纵隔囊肿9例,胸腺脂肪瘤3例,甲状腺肿1例,纵隔囊性淋巴管瘤1例,淋巴组织瘤样增生1例,脂肪组织增生1例。术后均无并发症。88例随访1～5年,均无复发。结论电视胸腔镜手术切除前纵隔肿瘤和囊肿安全可靠,切除彻底,具有微创、恢复快及并发症少的特点。

Video-assisted thoracoscopic resections in the treatment of anterior mediastinal tumors and cysts: report of 103 cases

Objective To evaluate the therapeutic methods and value of video-assisted thoracoscopic resections in the treatment of anterior mediastinal tumors and cysts. Methods The clinic data of 103 cases with anterior mediastinal tumors and cysts underwent completed video-assisted thoracoscopic resections(CVATR) or video-assisted thoracoscopic miniincision resections(VATMR) from July 1994 to July 2010 were analyzed retrospectively.There were 66 cases and 37 cases underwent CVATR and VATMR respectively. Results The complete resections were successfully performed in all 103 cases with no complication and death in the study.Average operation time was 80min,average bleeding was(100±35)ml,average thoracic cavity drainage time was(3.5±0.5)d and average hospitalization time was(7±0.8)d.Pathological examination showed mediastinal teratoma in 17 cases,thymus tumor in 34 cases,hyperplasia of thymus in 6 cases,bronchocele in 11 cases,thymus cyst in 15 cases,pericardial cyst in 4 cases,mediastinal cyst in 9 cases,thymolipoma in 3 cases,goiter in 1 case,cystic lymphangioma of mediastinum in 1 case,adipose hyperplasia in 1 case and nodular thyroid hyperplasia in 1 case.48 cases were followed up for 1 to 5 years and there were no complications. Conclusion CVATR and VATMR in the treatment of anterior mediastinal tumors and cysts are safe,reliable,excision completely,also have the advantages of less injury,quick recovery and few complications.