纵隔畸胎瘤临床表现与外科治疗策略(附64例分析)

CLINICAL MENIFESTATION AND SURGICAL STRATEGIES OF MEDIASTINAL TERATOMA (ANALYSIS OF 64 CASES)

目的 分析纵隔畸胎瘤的临床表现与外科治疗策略。方法 作者对 6 4例纵隔畸胎瘤作一综合分析。结果 男2 2例 ,女 42例。年龄 8～ 6 3岁 (平均 2 8.5岁 )。良性 6 1例 ,恶性 3例。无症状者 14例 ,伴呼吸道表现 32例 ,伴有胸痛者2 1例 ,伴中等发热者 15例 ,痰血 7例 ,伴胸腔积液 5例。外科治疗 :后外侧切口 36例 ,前外侧切口 12例 ,胸骨正中切口 12例 ,正中“T”形切口 4例。单纯肿瘤摘除术 2 6例 ;肿瘤摘除及邻肺楔形切除术 36例 ;肿瘤部分切除术 2例。结论 纵隔畸胎瘤具有侵蚀性强与周围组织粘连较重 ,使手术难度增加 ,分析其临床表现对于手术方案选择有一定的指导意义。

Objective To study the clinical manifestation and corresponding surgical strategies of mediastinal teratoma. Methods 64 cases of mediastinal teratoma were analysed. Results There were 22 male and 42 female in the group, aging 8 63 years old; 61 cases of benign teratoma and 3 cases of malignant teratoma were included. 14 cases were asymptomatic. 32 with respiratory manifestation, 21 with chest pain, 15 with fever, 7 with hemoptysis, and 5 cases of pleurisy. Surgical management: The number with postlateral, median, and median “T”shaped incision were 36, 12, 12, 4 cases respectively, 26 cases undergone simple resection of tumor, 36 accomplicating resection of the adjacent lung, 2 cases received partial tumor excision. Conclusion Mediastinal teratomas usually have characteristics of strong invasion, which makes simple resection inconvenient. Analysis on clinical signs preoperatively is helpful in the determination of surgical strategies.