原发性纵隔肿瘤手术方法的选择

目的探讨原发性纵隔肿瘤不同外科治疗.方法回顾分析近3年来该院收治的47例原发性纵隔肿瘤患者资料,根据采用的手术方法(正中开胸VS胸腔镜辅助小切口)分组,比较两组出血量、手术时间、术后住院时间、胸引时间、花费、并发症发生率的差别.结果全组病例均行手术,正中开胸手术18例,胸腔镜辅助小切口手术27例.其中胸腺瘤23例,占48.9%,畸胎瘤6例,占12.8%,神经源性肿瘤8例,占17%,其他纵隔肿瘤10例,占21.3%.胸腔镜辅助小切口组与正中开胸组比较,出血量、胸引时间、均明显降低,并发症发生率、住院时间较短.结论侧开胸胸腔镜辅助小切口可以完成所有纵膈区域(除甲状腺)手术,应作为纵膈肿瘤首先考虑的治疗方法;合并重症肌无力的胸腺瘤仍然以正中劈开胸骨行胸腺扩大切除为好.

Surgery of primary tumors of mediastinum

Objective To choose surgical methods to treat primary tumors of mediastinum. Methods] 47 cases of primary tumors of mediastinum were retrospectively analyzed in 3 years. 47 cases were randomly divided into open group and VATS group. Volume of bleeding, operation time, hospitation time, drainage time, expenditure and complications were compared. Results] 18 cases in open group while 27 in VATS group. 23 were thynoma (48.9%), 6 teratoma (12.8%), 8 nurogenic tumor, compared with open group , volume of bleeding, drainge time, complications and hospitation time in VATS group were decreased. Conclusions] VATS can be used in all mediastinum operation except for thyroid gland. Thynoma combined with myasthenia gravis might be treated by open method.