Nakajima Jun
Department of Cardiothoracic Surgery, University of Tokyo, Tokyo, Japan.
Kyobu Geka. 2005 Jul;58(8 Suppl):745-50.
Surgical treatment for old patients with mediastinal neoplasms except for those of thymic epithelial origin was retrospectively reviewed. Ten (7.5%) out of 133 patients who had underwent surgical therapy for extrathymic mediastinal tumors in our institute were no younger than 70. Two of them had malignant neoplasms (a germ cell tumor and a malignant fibrous histiocytoma). One (0.75%) 76-year-old patient with a thymic cyst had died of the pulmonary thromboembolism on the 3rd postoperative day. A 76-year-old patient with a malignant germ cell tumor had undergone reexploration because of persistent air leakage from the bronchopleural fistula. Surgical procedures were practically performed to determine the pathological diagnosis or to treat the patients with pathologically benign neoplasms because of diverse biological behaviors of these mediastinal tumors. In conclusion, surgical indications of the extrathymic mediastinal neoplasms should be more strictly limited and less invasive surgery should be applied to older patients as far as possible.
对除胸腺上皮源性肿瘤外的老年纵隔肿瘤患者的外科治疗进行回顾性分析。在我院接受胸外纵隔肿瘤手术治疗的133例患者中，10例（7.5%）年龄不小于70岁。其中2例患有恶性肿瘤（1例生殖细胞瘤和1例恶性纤维组织细胞瘤）。1例76岁胸腺囊肿患者术后第3天死于肺血栓栓塞。1例76岁恶性生殖细胞瘤患者因支气管胸膜瘘持续漏气而接受再次探查。由于这些纵隔肿瘤具有不同的生物学行为，手术实际上是为了确定病理诊断或治疗病理良性肿瘤患者。总之，胸外纵隔肿瘤的手术指征应更严格地限制，对于老年患者应尽可能采用侵入性较小的手术。
