巨大纵隔肿瘤的外科治疗

Surgical treatment of giant mediastinal tumor

目的 回顾总结 2 8例巨大纵隔肿瘤的诊断要点及外科治疗经验。方法 对 1980～ 2 0 0 2年收治的 2 8例巨大纵隔肿瘤的临床资料进行回顾分析。结果 2 8例中全部切除 2 3例姑息性切除 5例 ,其中肺楔形切除 2例 ,肺叶切除 1例 ,部分心包切除 5例 ,上腔静脉成形 1例 ,无手术死亡。结论 胸部X线、CT及B超是巨大纵隔肿瘤诊断的重要手段 ;麻醉时体位及手术切口的选择、术中操作技术注意可提高手术的安全性及切除率 。

Objective To review the experience of diagnosis and surgical treatment of 28 cases with giant mediastinal tumor.Methods The clinical data of 28 cases with giant mediastinal tumor were restroperctively analysized in our hospital from 1980 to 2002.Results Of the 28 cases,tumor of 23 cases had been successfully removed; 5 cases had been conducted palliative operation.Of 28 cases,wedge excision of pulmonary in 2 cases,lobectomy of lung in 1 case,partical pericardia excision in 5 cases,the superior vena cava plasty in 1case, no one died.Conclusion Besides X-ray,B-US and CT shoud be important preoperative diagnostic methods,body posture during induction anesthesia and the choice of the operation incision and surgical skill during operation can improve surgical safty and the rate of incision.Oozing of blood from the wound surface and additionally dilatant pneumoedema should be prevented and treated.