Rendina Erino A, Venuta Federico, De Giacomo Tiziano, Ciccone Anna Maria, Moretti Marco S, Ibrahim Mohsen, Coloni G Furio
Department of Surgery Paride Stefanini, University of Rome La Sapienza, Italy.
Ann Thorac Surg. 2002 Nov;74(5):1720-2; discussion 1722-3. doi: 10.1016/s0003-4975(02)03821-3.
Treatment of most primary mediastinal tumors is based on positive histological diagnosis; we describe a variation of anterior mediastinoscopy under local anesthesia. After infiltration with local anesthetic, a transverse skin incision is made in the second, third, or fourth interspace. The endothoracic fascia is incised vertically adjacent to the periosteum and a mediastinoscope is inserted in the mediastinum. Between 1995 and 2001, we have employed this technique in 46 patients with anterior mediastinal tumors. Histological diagnosis was obtained in all patients. Pneumothorax (2 patients) was drained by a tube removed at the end of the procedures. No other complications occurred and all patients were discharged from hospital within 24 hours. Mediastinoscopy under local anesthesia proved safe and effective for diagnosing anterior mediastinal tumors.
大多数原发性纵隔肿瘤的治疗基于阳性组织学诊断；我们描述了一种局部麻醉下前纵隔镜检查的变体方法。在局部麻醉浸润后，于第二、三或四肋间做一横形皮肤切口。在靠近骨膜处垂直切开胸内筋膜，将纵隔镜插入纵隔。1995年至2001年间，我们将该技术应用于46例前纵隔肿瘤患者。所有患者均获得了组织学诊断。2例患者发生气胸，在操作结束时通过置管引流。未发生其他并发症，所有患者均在24小时内出院。局部麻醉下纵隔镜检查被证明对诊断前纵隔肿瘤安全有效。
