[1]李剑,姜应梅,梁贵友,等.胸腔镜下双孔法治疗后纵隔肿瘤20例[J].中国微创外科杂志,2013,13(5):450-451.
　Li Jian,Jiang Yingmei,Liang Guiyou,et al.Videoassisted Thoracoscopic Surgery for Posterior Mediastinum Tumor with Two Trocars：A Report of 20 Cases[J].Chinese Journal of Minimally Invasive Surgery,2013,13(5):450-451.
点击复制

胸腔镜下双孔法治疗后纵隔肿瘤20例()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
13
期数:
2013年5期
页码:
450-451
栏目:
短篇论著
出版日期:
2013-05-20

文章信息/Info

Title:
Videoassisted Thoracoscopic Surgery for Posterior Mediastinum Tumor with Two Trocars：A Report of 20 Cases
作者:
李剑; 姜应梅; 梁贵友; 徐刚＊; 宋永祥; 陈成
遵义医学院附属医院胸心外科，遵义563003
Author(s):
Li Jian;  Jiang Yingmei;  Liang Guiyou;  et al.
Department of Cardiothoracic Surgery, Affiliated Hospital to Zunyi Medical College, Zunyi 563003,China
关键词:
胸腔镜; 后纵隔肿瘤
Keywords:
Thoracoscopy; Posterior mediastinum tumor
分类号:
R734.5
文献标志码:
A
摘要:
目的探讨胸腔镜下双孔法治疗后纵隔肿瘤的可行性。方法取健侧卧位前倾30°，于患侧腋中线第6肋间做1 cm长切口为胸腔镜观察孔，腋前线第3/4肋间做一3 cm长操作切口。经操作口置入电凝钩及吸引器，切开纵隔肿瘤外膜后使用圆头吸引器于包膜内钝性分离并完整切除肿瘤。结果手术均顺利完成，无中转开胸。平均手术时间46.5 min（35～78 min)，平均术中出血量65.5 ml(30～110 ml)，术后胸腔引流时间平均2.5 d(1～4 d)，术后平均住院4.5 d(3～7 d)。术后病理：神经纤维瘤8例，神经鞘瘤4例，畸胎瘤3例，支气管囊肿2例，淋巴结结核2例，脂肪瘤1例。20例随访6~12个月，无复发。结论胸腔镜下双孔法治疗后纵隔肿瘤安全可行。
Abstract:
ObjectiveTo summarize the experience of the treatment of posterior mediastinum tumor by videoassisted thoracoscopic surgery(VATS) with two trocars. MethodsThe patients assumed lateral position with a fore rake of 30°. A long incision of 1 cm was made in the six intercostals along the midaxillary line for observation. In the 3/4 intercostals along the anterior axillary line, a long incision of 3 cm was made. Hook and aspirator were put in through the long incision, and then blunt dissection and excision of the tumor were made by the round suction after the incision of the adventitia of mediastinal tumor. ResultsThe operation was completed successfully without conversion to thoracotomy. The average operation time was 46.5 min (from 35 to 78 min), with an average blood loss of 65.5 ml(30-110 ml), and an average postoperative drainage time of 2.5 d (from 1 to 4 d). The average hospitalization was 4.5 d(3-7 d). Pathology results: 8 cases of neurofibromatosis; 4 cases of neurilemmoma; 3 cases of teratomas; 2 cases of bronchocele; 2 cases of scrofula and 1 case of lipomyoma. Among the 20 cases, no recurrence was found during the followup of 6-12 months. ConclusionVATS with two trocars is safe and feasible for patients with posterior mediastinum tumor.

参考文献/References:

[1]Yamaguchi M, Yoshino I, Fukuyama S, et al. Surgical treatment of neurogenic tumors of t he chest. Ann Thorac Cardiovasc Surg,2004,10(3):148-151.
[2]王如文,蒋耀光,赵云平,等,电视胸腔镜胸腺切除治疗重症肌无力症.中国微创外科杂志，2004,4(1):21-23.
[3]Agasthian T, Lin SJ. Clinical outcome of videoassisted thymectomy for myasthenia gravis and thymoma. Asian Cardiovasc Thorac Ann,2010,18(3):234-239.
[4]李运,隋锡朝,卜梁,等.电视胸腔镜手术治疗后纵隔肿瘤.中国胸心血管外科临床杂志,2010,17(6):475-478.
[5]王强,郭剑波,马旺扣,等.完全胸腔镜下纵隔肿瘤切除术45例.中国微创外科杂志,2010,10(6):486-487.
[6][Salati M,Brunelli A,Xiume F,et al. Uniportal videoassisted thoracic surgery for primary spontaneous pneumothorax:clinical and economic analysis in comparison to the traditional approach. Interac Cardiovasc Thorac Surg,2008,7(1):63-66.
[7]Salati M, Brunelli A, Rocco G. Uniportal videoassisted thoracic surgery for diagnosis and treatment of intrathoracic conditions. Thorac Surg Clin,2008,18(3):305-310.
[8]郑家豪,曹子昂,梁而慷,等.原发性纵隔肿瘤的外科治疗.中国胸心血管外科临床杂志,2006,13(1):49-51.
[9]薛志强,初向阳,张连斌,等.单操作孔电视胸腔镜手术切除纵隔肿瘤32例临床分析.军医进修学院学报,2010,31(11)：1052-1053.

备注/Memo

备注/Memo:
＊通讯作者，Email:xglhl333@163.com
更新日期/Last Update: 2014-01-08