期刊文献+

胸顶部肿瘤外科治疗27例临床分析 被引量:9

Surgical treatment of apical chest tumor in 27 patients
原文传递
导出
摘要 目的 探讨前径路技术在胸顶部肿瘤手术治疗中的应用及其优势。 方法 从 1995年 1月至 2 0 0 1年 1月 ,手术治疗原发性胸顶部肿瘤患者 2 7例 ,平均年龄 4 9 2岁。病理类型包括非小细胞肺癌、肉瘤、神经纤维瘤、颈段食管癌等。通过对临床表现、肿瘤类型及外侵范围、手术径路及切除程度、并发症、生存期等资料进行分析 ,评估前径路对手术安全性和彻底性的帮助以及对延长生存期的作用。 结果  6例采用前径路半蛤壳切口 ,全部得到完全切除 ;2 1例采用后径路Paulson切口 ,其中 13例为完全切除 ,8例为姑息性切除。随访 2 3~ 4 6个月 (平均 2 9个月 ) ,总的中位生存期为2 1个月 ,其中完全切除者为 2 9个月 ,姑息切除者为 14个月 ,两者差异有显著意义 (P <0 0 1)。前径路的完全切除率明显高于后径路 (χ2 =1.6 78,P <0 0 1)。 结论 前径路切口可显著改善胸顶结构的暴露 ,尤其对于锁骨下血管、臂丛神经等结构可在直视下予以解剖 ,从而增加了手术的安全性和彻底性。 Objective To explore the“hemi-clamshell”approach to the resection of the apical chest tumors,and to evaluate its advantages of operative safety and completeness. Methods We conducted a retrospective review of the records of 27 patients undergoing resection of the primary apical chest tumors from January 1995 to January 2001. Tumor type included NSCLC,sarcoma,neurofibromatosis,esophageal carcinoma. Data collected included clinical presentation,tumor type and involvement,type of resection,complication,and survival. Results A clinical operation for gross-total resection of tumors and invaded structures was performed on six patients by means of a successful anterior approach. Among other 21 patients on whom a clinical operation was performed by posterior approach,only 13 patients obtained gross-total resection. There were significant difference between the two groups( P <0.01). The mean duration for follow-up was 29 months,and the overall median survival was 21 months. Median survival in patients undergoing gross-total resection was 29 months,and this is significantly better than in incomplete resection group( P <0.01). Conclusions The anterior“hemi-clamshell”approach is a successful technique for the exposure and resection of these tumors and invaded structures. Release of symptoms and long-term survival is acceptable if complete resection can be performed.
出处 《中华外科杂志》 CAS CSCD 北大核心 2004年第2期72-74,共3页 Chinese Journal of Surgery
关键词 胸顶部 肿瘤 治疗 临床分析 外科手术 诊断 Thoracic neoplasms Apical chest Anterior approach Thoracic surgical procedures
  • 引文网络
  • 相关文献

参考文献4

  • 1Dartevelle PG,Chapelier AR,Macchiarini P,et al.Anterior transcervical-thoracic approach for radical resection of lung tumors invading the thoracic inlet[].Journal of Thoracic and Cardiovascular Surgery.1993
  • 2Grunenwald D,Spaggiari L.Transmanubrial osteomuscular sparing approach for apical chest tumors[].The Annals of Thoracic Surgery.1997
  • 3Morton A,Krusna MJ,White CS,et al.Resection of primary brachial plexus tumor using a modified Dartevelle anterior approach[].The Annals of Thoracic Surgery.1999
  • 4Bains MS,Ginsberg RJ,Jones WG 2nd,et al.The clamshell incision: an improved approach to bilateral pulmonary and mediastinal tumor[].The Annals of Thoracic Surgery.1994

同被引文献48

  • 1王祖义,刘学刚,唐震,史向前,刘以尧,李小军.原发颈胸交界处非肺源性肿瘤的外科治疗[J].解剖与临床,2005,10(3):213-215. 被引量:7
  • 2刘吉福.颈胸倒“L”形小切口治疗颈胸结合区肿瘤临床分析[J].中华医学杂志,2006,86(8):570-571. 被引量:5
  • 3董孝成,范明生,孟繁彬,李孝恩.胸顶部肿瘤外科治疗23例临床分析[J].中国医师杂志,2007,9(6):812-813. 被引量:1
  • 4Kim DH, Murovic JA, Tiel RL, et al. A series of 397 peripheral neural sheath tumor: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg, 2005,102 : 246- 255.
  • 5Maiuri F, DonzeUi R, Benvenuti D, et al. Schewannomas of the brachial plexus--diagnostic and surgical problems. Zentralbl Neurochir,2001,62 :93-97.
  • 6Rawal A, Yin Q, Roebuck M, et al. Atypical and malignant peripheral nerve-sheath tumors of the brachial plexus: report of three cases and review of the literature. Microsurgery ,2006,26:80- 86.
  • 7Ferner RE, Lucas JD, O' Doherty MJ, et al. Evaluation of (18) fluorodesoxyglucose positron emission tomography ( ( 18 )-FDG PET) in the detection of malignant peripheral nerve sheath tumours arising from within plexiform neurofibromas in neurofibromatosis 1. J Neurol Neurosurg Psychiatry, 2000,68 : 353- 357.
  • 8Tender GC, Kline DG. Anterior supraclavicular approach to the brachial plexus. Neurosurgery ,2006,58 Suppl 2 : 0NS-360-364.
  • 9Matsui I, Tanimura M, Kobayshi N, et al. Neurofibromatosis type 1 and childhood cancer. Cancer,1993,72:2746-2754.
  • 10Marshall MB, Kucharczuk JC, Shrager JB, et al. Anterior surgical approaches to the thoracic outlet. J Thorac Cardiovasc Surg, 2006,131(6) :1255-1260.

引证文献9

二级引证文献16

;
使用帮助 返回顶部