Li Wilson W L, van Boven Wim Jan P, Annema Jouke T, Eberl Susanne, Klomp Houke M, de Mol Bas A J M
1 Department of Cardiothoracic Surgery, 2 Department of Respiratory Medicine, 3 Department of Anesthesiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands ; 4 Department of Thoracic Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands.
J Thorac Dis. 2016 Mar;8(3):E175-84. doi: 10.21037/jtd.2016.02.55.
Large mediastinal masses are rare, and encompass a wide variety of diseases. Regardless of the diagnosis, all large mediastinal masses may cause compression or invasion of vital structures, resulting in respiratory insufficiency or hemodynamic decompensation. Detailed preoperative preparation is a prerequisite for favorable surgical outcomes and should include preoperative multimodality imaging, with emphasis on vascular anatomy and invasive characteristics of the tumor. A multidisciplinary team should decide whether neoadjuvant therapy can be beneficial. Furthermore, the anesthesiologist has to evaluate the risk of intraoperative mediastinal mass syndrome (MMS). With adequate preoperative team planning, a safe anesthesiological and surgical strategy can be accomplished.
巨大纵隔肿物较为罕见，涵盖多种疾病。无论诊断如何，所有巨大纵隔肿物均可能导致重要结构受压或受侵，从而引起呼吸功能不全或血流动力学失代偿。详细的术前准备是取得良好手术效果的前提，应包括术前多模态影像学检查，重点关注肿瘤的血管解剖结构和侵袭特征。多学科团队应决定新辅助治疗是否有益。此外，麻醉医生必须评估术中纵隔肿物综合征（MMS）的风险。通过充分的术前团队规划，可以制定出安全的麻醉和手术策略。
