Aragaki Masato, Iimura Yasuyuki, Sato Nagato, Fukuda Naoya, Miyazaki Dai, Umemoto Kazufumi, Yoshida Yusuke, Hasegawa Naoto
Department of Cardiovascular and Thoracic Surgery, Hokkaido University, Graduate School of Medicine, Sapporo, Japan.
Kyobu Geka. 2016 Aug;69(9):760-3.
Various approaches can be applied to resect superior mediastinal tumor. It is important to choose the procedure according to the location, size, and characteristics of the tumor in order to perform safe procedure surgery because of distinctive anatomy of this site. We hereby report on a case of Schwannoma of the superior mediastinum resected by the transmanubrial approach. A 67-year-old woman was referred to our department to examine an abnormal chest shadow found at a regular health checkup. Computed tomography revealed a tumor 58×52 mm in size extending from the left supraclavicular fossa to the upper border of the aortic arch. The surgery was performed under the diagnosis of neurogenic tumor using the transmanubrial approach. The tumor was resected safely and the pathological diagnosis was a Schwannoma. Transmanubrial approach was found to be quite useful in securing an adequate visual field and enabling the safe separation of blood vessels and nerves from the tumor.
可采用多种方法切除上纵隔肿瘤。由于该部位独特的解剖结构，根据肿瘤的位置、大小和特征选择手术方式对于安全进行手术至关重要。我们在此报告一例经胸骨柄入路切除的上纵隔神经鞘瘤病例。一名67岁女性因常规体检发现胸部异常阴影转诊至我科。计算机断层扫描显示一个大小为58×52 mm的肿瘤，从左锁骨上窝延伸至主动脉弓上缘。在诊断为神经源性肿瘤的情况下，采用经胸骨柄入路进行手术。肿瘤被安全切除，病理诊断为神经鞘瘤。发现经胸骨柄入路在确保足够的视野以及使血管和神经与肿瘤安全分离方面非常有用。
