单操作孔胸腔镜胸顶部良性肿瘤的治疗体会

Experience in the Treatment of Benign Tumor on Apical Chest with Single Utility Port Thoracoscopic Surgery

目的:探讨单操作孔胸腔镜胸顶部良性肿瘤手术的可行性。方法:收集2017年1月至2021年3月在深圳大学第一附属医院行单操作孔胸腔镜手术治疗的胸顶部良性肿瘤患者7例,分析其临床效果及并发症。结果:所有患者肿瘤均顺利完整切除,神经鞘瘤4例,节细胞神经瘤2例,脉管瘤1例。手术时间85~145 min,平均(111.3±21.0)min;术中出血量20~50 mL,平均(37.1±12.5)mL;术后引流量80~240 mL,平均(161.4±54.3)mL。2例霍纳综合征,其中1例术后1月逐渐减轻,1年后随访部分功能恢复,另1例术前即有霍纳综合征,而术后病情加重,1年后随访无缓解;2例术侧上肢疼痛、麻木及活动受限,锻炼及理疗后逐渐缓解。无其它并发症发生。结论:单操作孔胸腔镜手术对经挑选的胸顶部良性肿瘤病例,创伤小、安全、有效。

Objective To explore the feasibility of single utility port thoracoscopic surgery for benign tumor on apical chest.Methods From January 2017 to March 2021,7 cases with benign tumor on apical chest underwent single utility port thoracoscopic surgery in our hospital were collected,and their clinical effects and complications were analyzed.Results Tumors were successfully and completely resected in all patients,including 4 schwannomas,2 ganglioneuromas and 1 vascular tumor.Operation time ranged from 85 to 145 minutes,with an average of(111.3±21.0)minutes;intraoperative blood loss was(20~50)mL,with an average of(37.1±12.5)mL;postoperative drainage volume was(80~240)mL,with an average of(161.4±54.3)mL.In 2 cases with Horner’s syndrome,one case gradually relieved at one month after operation,and some functions recovered after one-year follow-up;the other one had Horner’s syndrome before operation,but the postoperative condition was aggravated,and showed no remission after one-year follow-up;2 cases with upper limb pain,numbness and activity limitation on the surgical side were gradually relieved after exercise and physical therapy.No other complications occurred.Conclusion Single utility port thoracoscopic surgery is safe,effective and less invasive for selected cases with benign tumor on apical chest.