Department of Orthopaedic Surgery, Nagoya Graduate University School of Medicine, 65 Tsurumai Syowa-ward, Aichi 466-8550, Japan.
Yonsei Med J. 2012 May;53(3):611-7. doi: 10.3349/ymj.2012.53.3.611.
Thoracic dumbbell tumors are relatively rare, usually arising from neurogenic elements. Methods for surgical removal thereof remain controversial. The purpose of this study was to evaluate the surgical results of a single-stage posterior approach with laminectomy and costotransversectomy only for the management of thoracic dumbbell tumors.
Eight cases of thoracic large dumbbell tumor were analyzed retrospectively: seven men and one woman (mean age, 49 years). Pathologic findings included schwannoma in five patients, neurofibroma in two patients (Recklinghausen in one patient), and ganglioneuroma in one patient. All patients underwent single-stage removal of dumbbell tumors by a posterior approach followed by laminectomy and costotransversectomy combined with instrumentation. Clinical and radiologic outcomes were reviewed, thereafter.
Operative time ranged from 185 to 420 minutes (mean, 313 minutes), with estimated blood loss ranging from 71 to 1830 mL (mean, 658 mL). Postoperative complications included atelectasis in one case. All patients had tumors successfully removed with no neurological deterioration. Spinal deformities were not observed in any patients at the last follow-up (mean, 52 months), with instrumentation.
Single-stage surgery with laminectomy and costotransversectomy may be useful for removing thoracic dumbbell tumors without a combined anterior approach.
胸段哑铃形肿瘤较为少见，通常起源于神经源性组织。其手术切除方法仍存在争议。本研究旨在评估仅采用后路椎板切除和肋横突切除术一期手术治疗胸段哑铃形肿瘤的手术效果。
回顾性分析 8 例胸段大型哑铃形肿瘤患者资料：男 7 例，女 1 例；平均年龄 49 岁。病理检查结果：神经鞘瘤 5 例，神经纤维瘤 2 例（其中 1 例为 Recklinghausen 神经纤维瘤病），神经节细胞瘤 1 例。所有患者均采用后路一期手术切除哑铃形肿瘤，联合椎板切除和肋横突切除术，并进行内固定。术后对患者的临床和影像学结果进行评估。
手术时间为 185420 分钟，平均 313 分钟；术中估计出血量为 711830ml，平均 658ml。术后并发症包括 1 例肺不张。所有患者肿瘤均成功切除，且无神经功能恶化。末次随访时所有患者均未见脊柱畸形（平均随访时间 52 个月），且内固定在位。
对于无联合前路入路的胸段哑铃形肿瘤，采用椎板切除和肋横突切除术一期手术可能是一种有效的治疗方法。
