左前纵隔切开术联合纵隔镜检查对纵隔肿物的诊断价值

目的 探讨Chamberlain手术联合纵隔镜在不明原因的纵隔肿物诊断的价值.方法 采用左前纵隔切开入路,对胸部CT等检查发现的不明原因纵隔淋巴结肿大或纵隔占位尤其是经颈部纵隔镜难以达到的第5、6组淋巴结进行活检术,其中3例同期行心包开窗术.结果 59例患者均获得明确的病理诊断,确诊率达100%.3例心包积液患者同期行心包开窗术效果良好.本组手术时间平均短于1 h,手术出血量少于50 ml,术后平均住院天数为4 d,无手术死亡及术后并发症发生.结论 Chamberlain手术联合纵隔镜对于常规纵隔镜难以到达的第5、6组淋巴结肿大或不明原因的纵隔占位是一种安全有效的诊断手段.

Clinical Value of Chamberlain Procedure with Mediastinoscopy in Diagnosis of Anterior Mediastinal Mass

Objective To evaluate the value of parastemal anterior mediastinaotomy(Chamberlain procedure)with mediastinoscopy in diagnosis of anterior mediastinal mass or enlarged lymph node.Methods By Chamberlain procedure,biopsy was performed in 59 cases with anterior mediastinal mass or enlarged lymph node.All the patients were received CT scan before operation.Results All of 59 patients were made pathologic diagnosis 100% accuracy.Three patients with pericardial effusion underwent pericardial fenestration.All these patients recovered well without complication and death.Average operation time was 50 minutes,mean blood loss was about 50 ml,and average hospital stay after operation was 4 d.Conclusion Parasternal anterior mediastinaotomy(Chamberlain procedure)with mediastinoscopy is a safe and effective method in diagnosis of anterior mediastinal mass or enlarged lymph node.