巨大纵隔肿瘤的诊断和外科治疗

目的探讨巨大纵隔肿瘤的诊断和外科治疗经验.方法回顾分析1996年1月～2002年12月,38例巨大纵隔肿瘤患者的临床资料,其中男性27例,女性11例,良性肿瘤32例,恶性肿瘤6例,肿瘤平均直径10 m以上.1例在股静脉－股动脉体外循环下手术,1例术后出现气管软化,放置气管内支架.结果无围手术期死亡,随访3个月～3年,5例失访,1例术后1年因恶性淋巴瘤肝转移死亡,其他均恢复良好.结论术前应常规行CT检查,选择合适的麻醉及手术径路,术中可视情况分块切除或整块切除,术后注意防治气管软化和复张性肺水肿.

Diagnosis and surgical treatment for giant tumor of mediastinum

Objective To review the experience of diagnosis and surgical treatment for giant tumor of mediastinum. Methods Thirty eight patients with giant tumor of mediastinum were treated surgically from Jan. 1996 to Dec. 2002, including 27 men and 11 women. 32 cases were benign tumors, and 6 cases were malignant tumors. The average diameter of the tumors was more than 10 cm. Femorofemoral cardiopulmonary bypass was used in one patient, and metallic stent was inserted in one patient against the stenosis of trachea. Results There was no perioperative death occurred. During the period of 3 months to 3 years after operation, five cases lost in follow up, one case died from metastasis of malignant lymphademoma, others recovered nicely. Conclusion The routine preoperative CT examination, proper anesthesia and surgical route were equally important. Postoperative management includes prevention of the occurrence of sunken trachea and dilatant pneumoedema.