跨解剖区域颈根部神经源性巨大软组织肿瘤的手术疗效分析

Surgical treatment of tremendous neurogenic tumors in the root of neck

目的 回顾及探讨6例颈根部神经源性巨大肿瘤患者的手术治疗方法、疗效及手术经验.方法 应用颈胸腋手臂联合改良大“T”形切口入路整体切除颈根部神经源性巨大肿瘤,观察手术效果和患者的预后.结果 顺利切除6例患者颈根部巨大神经纤维瘤及神经纤维肉瘤.肿瘤最大长径12.0～ 18.0 cm,中位长径为15.5 cm.肿瘤侵及或者压迫臂丛神经、锁骨下动静脉、第1、2肋骨、肩胛骨及颈椎旁.术后未出现明显危及生命的手术并发症.本组患者术后随访2～6年,中位随访时间4.5年.其中1例神经纤维瘤病患者术后11个月出现椎管内复发病灶,术后1年死亡,其余5例目前疗效满意.结论 对跨解剖区域的颈根部晚期肿瘤患者,手术治疗是唯一有效的方法.手术入路的选择对颈根部巨大肿瘤侵及邻近胸腔及周围组织的处理提供了良好的思路和治疗方案.

Objective To evaluate surgical treatment outcomes in 6 cases with tremendous neurogenic tumors in the root of neck.Methods Neck-chest-axil-arm ＂T＂ incision was used to remove huge tumor in the root of neck.Results The tumors in the root of neck in 6 patients were removed successfully and no serious complication occurred.With postoperative follows-up for 2-6 years （median 4.5 years）,only 1 case died due to the recurrence of lesion in vertebral canal in 11 months after surgery and the other cases survived with satisfying therapeutic outcomes.Conclusion Surgery is an effective method to remove advanced tumor in the root of neck and to improve the quality of life for the patients.