电视胸腔镜辅助下切除后纵隔神经源性哑铃形肿瘤

目的:探讨微创技术在后纵隔神经源性哑铃形肿瘤切除手术中的应用.方法:2001年3月-2004年3月对本院胸心外科11例后纵隔神经源性肿瘤患者与神经外科联合手术,小切口切除肿瘤椎管内部分,在电视胸腔镜辅助(VATS)下切除肿瘤椎管外部分.结果:10例患者用微创技术完整切除肿瘤,切除率100%,无1例出现血胸、神经根损伤、椎管内血肿、肺损伤及脑脊漏等并发症;1例因肿瘤巨大占据胸腔,附加一前外侧小切口,亦完整切除肿瘤.随访6个月至2年无1例复发.结论:与传统手术径路比较,背部小切口 VATS在后纵隔哑铃形肿瘤切除术中具有创伤小、暴露好、并发症少、Ⅰ期完整切除肿瘤、局部复发率低等优点,临床值得推广应用.

Removal of Neurogenic Dumbbell-Shaped Postmediastinal Tumor with Video Assisted Thoracoscopic Surgery

Objective:To investigate the use of minimally invasive surgery in resection of dumbbell-shaped postmediastinal tumor.Methods: Between March 2001 and March 2004,11 cases of postmediastinal neurogenic tumors were surgically treated in our hospital,assisted by Dept of Neurosurgery.The intraspinal section of the tumor was removed through small incision,and the extraspinal section removed by video-assisted thoracoscopic surgery(VATS).Results: All 11 cases were successful with complete removal of the tumor.None was complicated with hemothorax,radicular injury,intraspinal hematoma,lung injury or CSF leakage.One case with a large tumor required an additional incision for complete resection.No recurrence was noted during a follow up for 6-24 months.Conclusion: Compared with conventional approach,a small dorsal incision plus VATS showed preferable clinical advantages in less injury,good exposure,fewer complications,complete I stage resection and low incidence of local recurrence.