前纵隔病变微创切除手术的治疗进展

Recent Progress of Minimally Invasive Surgery in Anterior Mediastinal Diseases

胸腔镜手术切除前纵隔病变具有创伤小、出血少、恢复快、并发症少等优点,是一种安全、有效的手术方法。不同入路的腔镜手术各有所长。单侧入路创伤小,但对侧病变区域操作困难;双侧入路清扫范围广泛,但术中需改变手术体位;颈胸双入路对于无名静脉以上组织有一定优势,但创伤相对大;单孔操作创伤小,但手术操作难度大,手术视野局限;三孔操作范围广、创伤小;机器人手术清扫范围大,操作安全精细,但手术治疗费用高。

Thoracic surgery is a safe and effective method to remove the anterior mediastinal lesions with less trauma,less bleeding, faster recovery,less complications and so on. Different approaches of laparoscopic surgery have different advantages. Unilateral approach is featured with less trauma, but also has the disadvantage of difficult operation on the contralateral lesions ; bilateral approach has a wide clearance range, but needs to change the body position during operation ; neck-chest dual approach has certain advantages for the innominate vein above tissue, but has larger trauma; single hole operation has less trauma, but the difficulty of operation is greater, and the operation field is limited;three-hole approach is featured with wide operation range and smart truma;the robot operation has a wide clearance range and fine operation safety ,but the operation cost is high.