胸腔镜手术治疗纵隔神经源性肿瘤45例的临床分析

目的：探讨胸腔镜在纵隔神经源性肿瘤手术治疗中的应用。方法：对本院1994年7月-2008年10月45例经手术切除并经病理证实的纵隔神经源性肿瘤进行回顾性分析。结果：45例均经胸腔镜手术完整切除，5例辅以小切口完成。肿瘤平均直径4．06cm，术中出血量（108．28±137．27）mL，拔管时间（1．64±0．85）d，术后胸管引流（256．20±178．45）mL，术后住院时间（6．96±3．35）d，1例出现并发症。随访1月-14年，无肿瘤复发。结论：胸腔镜对于纵隔神经源性肿瘤，特别是后纵隔的神经源性肿瘤具有操作简便、创伤小、恢复快、并发症少的特点，而且对于一些较为复杂的神经源性肿瘤，在小切口辅助下也能安全完成，应作为首选的治疗方法。

The Clincical Analysis of 45 Cases of Video-assisted Thoracic Surgery to Treat The Neurogenic Tumors of Mediastinum

Objective： To approach the application of Video-assisted thoracic surgery （VATS） in neurogenic tumors of mediastinum. Methods ： Retrospectively analyzes the 45 patients from Jul 1994 to Oct 2008 in our hospital, who certified the neurogenic tumors by pathology. Results：45 cases resected by VATS, all tumors could be resected completely. 5 cases assisted with small incision. The average tumor size is 4.06 cm （ all use the average statistics below）, blood loss through the operation is 98.38 mL, The thoracic drainage time is 1.51 days, the volumn of drainage is 229.74 mL, the lenth of stay after operation is 6.81 days, l case emerge complications after operation. Follow-up visit from 1 month to 14 years, no tumor recurrence. Conclusion：VATS should be the first choice of neurogenic tumors, because of the easier handling, less trauma, faster recovery and less complications, especially suitable for the tumors located in the posterior mediastinum. For some cases of complicated situations, we can use Mini-invasive thoracotomy combined with VATS to finish.