电视胸腔镜治疗后纵隔神经源性肿瘤85例

Video-assisted thoracoscopic resection of posterior mediastinal neurogenic tumors:an analysis of 85 cases

目的:探讨电视胸腔镜治疗后纵隔神经源性肿瘤的价值。方法:2001年7月至2012年3月,胸腔镜切除后纵隔神经源性肿瘤85例,其中6例胸腔-椎管哑铃型神经源性肿瘤,完全电视胸腔镜下切除72例,胸腔镜辅助小切口下切除10例,中转开胸3例。结果:手术顺利,手术时间平均95.3min,术后病理神经鞘瘤42例,神经纤维瘤22例,神经节细胞瘤21例。随访9个月～9年,无局部复发。结论:电视胸腔镜手术切除后纵隔神经源性肿瘤安全、微创、恢复快,可作为该疾病的首选治疗方法。胸腔-椎管哑铃型神经源性肿瘤由胸外科和神经外科医师共同完成。

Objective To evaluate the therapeutic value of video-assisted thoracoscopy in treating posterior mediastinal neurogenic tumors. Methods A retrospective study included 85 patients with posterior mediastinal neurogenic tumors from Jul 2002 to Mar 2012 carried out in our institution. Among them, 6 cases with dumbbell tumours. The complete video-assisted thoraeoscopic surgery were performed in 72 cases, 10 cases combined with mini-incision and 3 cases were converted to thoracotomy. Results All operations were successfully finished. The average duration of surgery was 95.3 min ; Pathological examination showed 42 cases were with neurilemoma, 22 cases were with neurofibroma, and 21 cases were with paraganglioma. The time of follow-up was 9 months to 9 years, and no relapse was found in this study. Conclusions VATS is a safe, minimally invasive and quick recovery operation in the treatment for posterior mediastinal neurogenic tumors and can be regarded as first line therapy for patients with posterior mediastinal neurogenic tumors.