恶性胸腺肿瘤的手术治疗

Surgical treatment of malignant thymoma

目的 总结6年间手术治疗的108例恶性胸腺肿瘤的经验。方法 按肿瘤大小及位置分别采用胸骨正中切口和/或前外侧切口、后外侧切口施术。结果 恶性胸腺肿瘤极易发生心包及前纵膈大血管浸润,术中难以将肿瘤完整切除,能够完整切除者常需合并大血管切除或置换术。肿瘤有残留组术后剖面追加放射治疗,其1年、3年生存率仅略低于完整切除组而明显高于单纯探查组(P<0.01)。结论 恶性胸腺肿瘤手术的原则是即使不能完整切除肿瘤也应尽量将可切除部分切除。

Objective To review the experience of 108 patients with malignant thymoma surgical treatment. Methods According to size and position of thymoma. The operation was done respectively through median sternoto-my plus(or) anterior thoracotomy,posterior thoracotomy. Results Malignant thymoma often infiltrated to pericardium and large blood vessle in anterior mediastum easily,it was difficult to resect the tumor radically if the surgeon did not combine with large blood vessle resection of replacement. The palliative resection were suggested to accept radiotherapy after operation,so the one-year and three-year survival rates were just lower then those of patients with radical resection, but it was statistically significant higher than those of patients with exploration group( P < 0.01) . Conclusion Surgical principle of malignant thymoma if we could not resect the tumor radically,we should resect tumor as clearly as possible.