改良剑突下入路胸腔镜前纵隔畸胎瘤切除术的临床应用分析

Clinical application of modified subxiphoid approach or thoracoscopic mediastinal teratoma resection

目的:探讨改良剑突下入路胸腔镜前纵隔畸胎瘤切除术的临床疗效和安全性。方法:回顾性分析经病理确诊的前纵隔畸胎瘤患者17例,均行改良剑突下入路胸腔镜前纵隔畸胎瘤切除术,观察患者的临床疗效及手术安全性。结果:17例患者均在胸腔镜下顺利完成手术,其中,2例患者合并行心包部分切除术,1例患者合并行右肺楔形切除术。肿瘤标本切除完整,切除肿瘤标本平均直径为(8.4±1.7) cm;手术平均时间为(67.8±17.3) min,术中平均出血量为(48.8±31.6) mL,术后平均引流量为(73.5±11.1) mL,术后平均住院时间为(3.8±1.0) d。所有患者无手术并发症,均顺利出院。结论:改良剑突下入路胸腔镜前纵隔畸胎瘤切除术安全、可靠,患者疗效满意,值得临床推广。

Objective:To explore the clinical efficacy and safety of modified subxiphoid approach for thoracoscopic mediastinal teratoma resection.Methods:A total of 17 cases of mediastinal teratoma confirmed by pathology examination and underwent thoracoscopic mediastinal teratoma resection using the modified subxiphoid approach were retrospectively analyzed, and the clinical efficacy and surgical safety of the patients were investigated. Results:All of the 17 patients underwent successful thoracoscopic surgery. Two patients underwent partial pericardial resection. In one patient, the right lung wedge resection was performed. The tumor specimens were completely resected, and the mean diameter of the resected tumor specimens was (8.4±1.7) cm, the mean operation time was (67.8±17.3) minutes, the mean intraoperative blood loss was (48.8±31.6) mL, the mean postoperative drainage was (73.5±11.1) mL, and the mean postoperative hospital stay was ( 3.8±1.0) days. All patients were discharged without significant postoperative complications. Conclusions:The modified subxiphoid approach for thoracoscopic mediastinal teratoma resection is safe, reliable, and satisfactory. It is worthy of clinical promotion.