儿童原发性支气管肿瘤15例的外科治疗及疗效评估

Surgical treatment and outcome of primary tracheobronchial tumors in 15 children

目的探讨儿童气管肿瘤的临床特征,分析其临床治疗方案及预后。方法收集2009年5月至2021年1月期间广州市妇女儿童医疗中心收治儿童气管肿瘤患儿的临床资料,包括临床表现、影像学特征、手术方案及辅助治疗等,并进行回顾性分析。结果15例患儿纳入研究,其中包括:黏液表皮样癌7例,肺炎性肌纤维母细胞瘤4例,尤因肉瘤1例,滑膜肉瘤1例,婴儿血管瘤1例,神经纤维瘤1例。本组患儿中多以呼吸道症状就诊,包括咳嗽15例,气促1例,发热8例,咳血2例。ECMO辅助下支气管镜主气管肿物切除术1例,袖状切除术3例,左侧全肺切除术1例,肺叶切除术5例,肺段切除术4例。4例肺段切除患儿均术后复发,2例二次手术。结论儿童肺部肿瘤缺乏特异性临床表现。手术完整切除有利于取得良好预后。气管内局限性肿物建议行纤维支气管镜手术切除。

Objective To investigate the clinical manifestation,pathological types,treatment and prognosis of primary tracheobronchial tumors in children.Methods We retrospectively studied the primary tracheobronchial tumors patients who diagnosed from May 2009 to Jan 2021 in Guangzhou Women and Children Medical Center.The clinical manifestations,pathological types,therapeutic methods and prognosis were analyzed.Results There were 15 patients identified as the primary tracheobronchial tumors,including synovial sarcoma(1 case),pulmonary inflammatory myofibroblastic tumor(IMT 4 cases),mucoepidermoid carcinoma(7 cases),infantile hemangioma(1 case),Ewing's sarcoma(1 case).Respiratory symptoms are the most complaint at the time of diagnosis including 15 patients with cough,2 with hemoptysis,and 1 with dyspnea.Endoscopic treatment of tracheobronchial tumors was performed under extracorporeal membrane oxygenation(ECMO)support in 1 patient.Sleeve lobectomy was performed in 3 patients,lobectomies in 6,and local tumor resections in 4 patients including 2 patients suffered second surgery due to tumor recurrence.Conclusion The clinical manifestations of the primary tracheobronchial tumors in children are nonspecific.Complete resection led to excellent outcome.