[1]叶敏华,陈保富,叶中瑞,等.电视胸腔镜手术治疗前纵隔小结节32例[J].中国微创外科杂志,2009,09(7):638-639.
　Ye Minhua,Chen Baofu,Ye Zhongrui,et al.Videoassisted Thoracoscopic Surgery for Anterior Mediastinal Nodules: Report of 32 Cases[J].Chinese Journal of Minimally Invasive Surgery,2009,09(7):638-639.
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电视胸腔镜手术治疗前纵隔小结节32例()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
09
期数:
2009年7期
页码:
638-639
栏目:
出版日期:
2009-08-25

文章信息/Info

Title:
Videoassisted Thoracoscopic Surgery for Anterior Mediastinal Nodules: Report of 32 Cases
作者:
叶敏华; 陈保富; 叶中瑞; 朱成楚
浙江省台州医院胸外科，临海317000
Author(s):
Ye Minhua;  Chen Baofu;  Ye Zhongrui;  et al.
Department of Thoracic Surgery, Taizhou Hospital, Linhai 317000, China
关键词:
电视胸腔镜手术; 前纵膈结节
Keywords:
Videoassisted thoracoscopic surgery; Anterior mediastinal nodules
分类号:
R655.5
文献标志码:
A
摘要:
目的探讨电视胸腔镜手术治疗前纵隔小结节的可行性。方法前倾45°侧卧位，采用30°胸腔镜。观察孔位于患侧腋中线第5或第6肋间。分别取锁骨中线第2或第3肋间、腋前线第5肋间做操作孔。直接切除结节；如果结节隐蔽，将全部胸腺连同前纵隔脂肪一并切除。结果32例均在胸腔镜下完成结节切除，3例术中因出血辅助小切口进胸止血。术后病理诊断：胸腺瘤14例，胸腺增生3例，胸腺囊肿5例，支气管囊肿3例，心包囊肿2例，神经鞘瘤2例，淋巴结2例，血管瘤1例，术前后病理诊断符合率68.8%（22/32）。术后并发症2例，包括1例心包积液，1例肺部感染，均经对症治疗后痊愈出院。28例随访1～5年，其中<2年6例，2～5年22例，均无局部复发。结论电视胸腔镜手术治疗前纵隔小结节具有创伤小、痛苦轻、恢复快、外观效果好、诊断明确等优势，非常适合年轻和肺功能低的患者。
Abstract:
ObjectiveTo investigate the feasibility of videoassisted thoracoscopic surgery for anterior mediastinal modules. MethodsThoracoscopic surgery was performed with the patients in supine position and the thoracoscope set at 30°. Three trocars were used during the procedure. One of the trocars was inserted through the fifth or sixth intercostal space at the midaxillary line for direct observation. And the other two were placed at the second or third intercostal space at the midclavicular line, and the fifth intercostal space at the anterior axillary line. The nodules were removed directly during the operation. For inseparable nodules, the whole thymus and the fat tissues in the anterior mediastinum were removed all together.ResultsThe procedure was completed under a thoracoscope in all of the 32 cases. Small assistant incision was made in 3 cases because of hemorrhage in the chest cavity. Postoperative pathological examination showed thymus tumor in 14 cases, hyperplasia of the thymus in 3, thymic cyst in 5, bronchial cyst in 3, pericardial cyst in 2, neurilemmoma in 2, lymph node in 2, and angioma in 1. The accordance rate of pre and postoperative diagnosis was 68.8% (22/32). Postoperative complications were found in two patients, including one case of pericardial effusion, and one case of lung infection. Both the cases were cured afterwards.ConclusionsThoracoscopic surgery is a minimally invasive procedure for the treatment of anterior mediastinal nodules. It is optimal for young patients and cases with low lung function, as it causes less pain, quicker recovery,and satisfying cosmetic outcomes.

参考文献/References:

[1]李旭,涂远荣,林敏,等.电视胸腔镜纵隔肿瘤手术46例报告. 福建医科大学学报, 2006,40:658.
[2]梁正,刘丹丹,沈祯云,等.胸腔镜纵隔肿瘤的诊断和治疗.中国微创外科杂志,2003,3:222-223.
[3]叶国麟,谭家驹,杨劼,等.电视胸腔镜手术对纵隔疾病的诊治.中国内镜杂志,2004,10:35-37.
[4]陈保富,朱成楚,叶中瑞,等.纵隔肿瘤的电视胸腔镜手术治疗.浙江医学,2007,29:60-62.
[5]陈应泰,王俊,刘军,等.纵隔肿瘤的胸腔镜手术治疗.中国微创外科杂志,2002,2:283-285.

更新日期/Last Update: 2013-09-17