摘要
目的 探讨左前纵隔切开术在不明原因的纵隔淋巴结肿大和前纵隔占位诊断中的价值。 方法 采用左前纵隔切开入路 ,对 32例胸部CT等检查发现的不明原因纵隔淋巴结肿大或纵隔占位进行活检术。 结果 32例均获得明确的病理诊断 ,确诊率达 10 0 % (32 / 32 )。 3例心包积液同期行心包开窗术 ,心包填塞症状缓解。 4例同期行肺活检术。本组手术时间 (48± 15 )min ,术中出血量 (40 6± 2 3 5 )ml,术后住院 (3 6± 1 4 )d ,无手术死亡及术后并发症发生。 结论 左前纵隔切开术对于常规颈部纵隔镜难以到达的第 5、6组淋巴结肿大或不明原因的纵隔占位是一种安全有效的诊断手段 ,并可同时尝试进行诸如肺活检术、心包开窗术等一些简单的治疗。
Objective To explore the value of left parasternal anterior mediastinaotomy (Chamberlain procedure) in the diagnosis of mediastinal lymph node enlargement with unknown causes and anterior mediastinal space-taking lesions. Methods By using the Chamberlain procedure, biopsy was performed in 32 cases of enlarged mediastinal lymph nodes with unknown causes or mediastinal space-taking lesions, which were found by CT scans. Results All of the 32 cases were pathologically diagnosed, with a diagnostic accuracy of 100%. Three patients with pericardial effusion received concurrent pericardial fenestration and then their symptoms relieved. Four patients underwent concurrent lung biopsy. The operating time was (48±15) min, the blood lose was ( 40.6±23.5) ml, and the postoperative hospital stay (3.6±1.4) days. No deaths or postoperative complications occurred. Conclusions Chamberlain procedure is a safe and valuable method in the diagnosis of mediastinal space-taking lesions with unknown causes or enlargement of the fifth and sixth groups of mediastinal lymph nodes, which routine mediastinoscope cannot reach. Some other simple therapies, such as lung biopsy or pericardial fenestration, can also be employed at the same time.
出处
《中国微创外科杂志》
CSCD
2004年第1期19-20,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
纵隔肿瘤
左前纵隔切开
纵隔镜
Mediastinal tumor
Left parasternal anterior mediastinaotomy
Mediastinoscope
