摘要
目的 探讨胸腔镜纵隔肿瘤切除的可行性。 方法 本组 39例 ,男 2 0例 ,女 19例。年龄(2 5～ 75 )岁 ,平均 4 4 9岁。术后病理诊断胸腺瘤 13例 ,浸润性胸腺瘤 2例 ,神经源肿瘤 10例 ,食管囊肿3例 ,支气管囊肿 3例 ,心包囊肿 2例 ,成熟畸胎瘤 1例 ,其它 5例。全麻双腔插管 ,侧卧位 ,健侧单肺通气。通常胸腔镜Trocar置于腋前线至腋后线的第 6、7肋间 ,操作套管 2个～ 3个 ,如术中探查肿瘤直径过大 ,切下后难以经Trocar取出 ,或因粘连严重显露困难等原因 ,可以辅以小切口完成肿物切除。 结果 36例经胸腔镜完成肿物切除 ,3例附加 8cm小切口完成手术。术后恢复好 ,无围手术期并发症及死亡发生。 结论 胸腔镜手术创伤小 ,安全有效 ,适合于多数纵隔肿瘤的诊断和治疗 ,尤其是对大多数纵隔良性肿瘤的切除较传统的开胸手术具有明显优势。
Objective To explore the feasibility of Video-Assisted Thoracic Surgery(VATS)in the treatment of mediastinal diseases. Methods 39 patients underwent VATS for mediastinal diseases from May 1994 to February 2002.There were 20 males and 19 females with a mean age of 44.9 years(range 25～75 years).13 patients with thymoma,2 patient with invasive thymoma,10 patients with neurogenic benign tumor,3 patients with esophagus cyst,3patients with bronchus cyst,2 patient with pericardial cyst,1 patient with teratoma and 5 patients with other conditions were included in the study.General anesthesia,double lumen endotracheal tube placement and single lung ventilation were used.The patients were placed in the lateral decubitus position with 15° slope forward for posterior mediastinal mass or with 15°～30° slope backward for anterior mediastinal mass.The camera port was placed in the sixth or the seventh intercostal space between the anterior anxillary line and posterior anxillary line.Two or three ports placed according to the site of the tumor permitted an adequate working distance that maximized the range of dissection within the chest.Mini-invasive thoracotomy combined with VATS were performed for some patients when the solid tumor was more then 5 cm in diameter or when it was closely adhesire to surrounding organs Results All patients recovered uneventfully.36 patients underwent tumor removal by VATS alone and 3 patients received mini-invasive thoracotomy combined with VATS performance.The overall incidence of postoperative complication and mortality rate were 0. Conclusions VATS is a safe and effictive technique in the selective patients with mediastinal masses.
出处
《中国微创外科杂志》
CSCD
2002年第5期283-285,共3页
Chinese Journal of Minimally Invasive Surgery
