心包囊肿的外科治疗及微创技术的应用

Surgical Treatment of Pericardial Cyst and Application of Minimally Invasive technique

目的总结我院心包囊肿外科治疗的经验,通过对不同心包囊肿手术入路进行分析,讨论微创技术的应用情况。方法患者36例,均行择期手术。开胸切除囊肿18例,其中正中加胸骨横断切口1例,侧开胸12例,肋间微创小切口(10cm)5例;胸腔镜手术8例,其中胸腔镜辅助小切口(6～8cm)6例,完全胸腔镜手术2例;全机器人手术6例;CT引导下穿刺抽液4例。对不同手术方式所用手术时间,住院时间及随访结果进行记录。结果全部患者治愈出院。1例侧开胸者切口感染。随访32例,平均随访时间3～6个月,1例行CT引导下穿刺抽液者复发,其余均未见复发。结论心包囊肿首选手术治疗,其效果良好。随着微创方式的改进,创伤越来越小,手术和住院时间呈现越来越短的趋势,尤其是机器人技术优势明显,显示了微创技术良好的应用前景。

Objective To summarize the experience of surgical treatment of pericardial cyst and analyze the application of the minireally invasive technique. Methods From 1996 to 2010,the clinical data of 36 cases with pericardial cyst were retrospectively analyzed. Traditional procedure via thoracic incision was performed in 18 patients. One patient of them received median incision plus sternum transaction and five patients received small intercostal incision （10cm）. Thoracoscope - assisted cyst excision was performed in eight cases of whom six received micro - invasive incision （6 -8cm）. Robotic cyst excision was performed in 6 cases. CT - guided cyst centesis was performed in four patients. The operation time and length of stay were recorded. Results There was no hospital death. Pericardial cyst was proved by pathologic diagnosis. The operation time and hospital stay showed a decreasing tendency with the improvement of micro - inva- sive technique. There were 32 patients followed - up for 3 - 6 months and recurrence was occured in 1 case who had received CT - guided cyst centesis. Conclusion Surgical treatment is the optimal therapy for pericardial cyst, Micro - invasive technique such as robotic procedure showed obvious advantages comparing with traditional operation.