心包囊肿27例诊治体会

Experiences in diagnosis and treatment of pericardial cyst：a report of 27 cases

目的探讨心包囊肿影像表现的多样性以及外科诊治的特点，进一步评价胸腔镜等微创技术在心包囊肿治疗上的应用价值。方法收集1996年1月至2010年12月间收治的心包囊肿患者的病历资料，提取相应临床数据，对其进行回顾性分析。结果全组共27例患者，21例无自觉症状，多数病变影像表现典型，但有6例病变位置特殊，术前未能准确诊断。全组患者均接受手术治疗，其中14例采用微创技术完成，与常规手术相比微创手术在术后住院时间上明显缩短。全组均获得完整切除，无并发症发生，术后均经病理证实为心包囊肿。结论心包囊肿影像表现多样，可出现于心包的任何部位，在诊断纵隔囊肿时均应考虑到心包囊肿的可能。心包囊肿一经诊断应该尽早手术治疗。根据囊肿特点选择合适的手术方法是获得良好治疗效果的关键，胸腔镜等微创技术适合于心包囊肿的治疗。

Objective To explore the image performance,clinical features and surgical treatment of pericardia1 cysts and to evaluate the application of minimally invasive surgery, such as thoracoseopy, in the surgical treatment of pericardial cysts. Methods The medical records and clinical data of patients with pericardial cysts who were admitted in our department from January 1,1996 to December 31,2010 were reviewed retrospectively. Results A total of 27 patients were included, of which 21 were without symptoms. Most were typical in lesion imaging findings, but there were 6 cases of lesions in unusual posi- tion not acquiring accurate preoperative diagnosis. All the patients underwent surgical procedures, in which 14 received minimally invasive surgical technique. Compared with conventional surgery, minimally invasive surgery was significantly shorter in postoperative hospitalization time. All patients were given radical resec- tion. There was no surgery related mortality or complications in any patients. The diagnosis of perieardial cysts was confirmed by postoperative histopathological examination. Conclusion The imaging performance of perieardial cysts is diverse and can be seen in almost any part of the pericardium. The possibility of peri- cardial cyst should be taken into account when diagnosing mediastinal cyst. Pericardial cysts should be treated surgically as soon as possible once diagnosed. Appropriate operation according to the characteristics of pericardial cysts is the key to good curative effect, and minimally invasive technique such as thoracosco- py surgery is the prior choice.