Nam Kyoung Hyup, Ahn Hyo Yeoung, Cho Jeong Su, Kim Yeoung Dae, Choi Byung Kwan, Han In Ho
Department of Neurosurgery, Medical Research Institute, Pusan National University Hosptial, Busan, Korea.
Department of Thoracic and Cardiovascular surgery, Medical Research Institute, Pusan National University Hosptial, Busan, Korea.
J Korean Neurosurg Soc. 2017 Mar;60(2):257-261. doi: 10.3340/jkns.2016.0909.004. Epub 2017 Mar 1.
This study was conducted to assess the surgical results of one-stage posterior minimal laminectomy and video-assisted thoracoscopic surgery (VATS) for the treatment of thoracic dumbbell tumor and to describe its precise technique. In addition, we investigated the technique's usefulness and limitations.
Seven cases of thoracic dumbbell tumor (two men and five women, mean age, 43 years) were analyzed retrospectively. Pathological findings included schwannoma in four patients, neurofibroma in two patients, and hemangioma in one patient. The location of tumors varied from T2/3 to T12/L1. Dumbbell tumors were resected by one-stage operation using posterior laminectomy followed by VATS without instrumentation. Clinical data were reviewed.
The mean follow-up period was 25 months (range, 3-58 months), and the operative time ranged from 255 to 385 min (mean, 331 min), with estimated blood loss ranging from 110 to 930 mL (mean, 348 mL). The tumor was completely resected without instrumentation and postoperative instability in all cases. Postoperative complications included atelectasis and facial anhydrosis in one case each.
One-stage posterior minimal laminectomy and VATS may be a safe and less invasive technique for removal of thoracic dumbbell tumor without instability. This method has the advantage of early ambulation and rapid recovery because it reduces blood loss and postoperative pain.
本研究旨在评估一期后路微创椎板切除术和电视辅助胸腔镜手术（VATS）治疗胸段哑铃形肿瘤的手术效果，并描述其精确技术。此外，我们还研究了该技术的实用性和局限性。
回顾性分析7例胸段哑铃形肿瘤患者（2例男性，5例女性，平均年龄43岁）。病理结果包括4例神经鞘瘤、2例神经纤维瘤和1例血管瘤。肿瘤位置从T2/3至T12/L1不等。采用一期手术，先行后路椎板切除术，然后行VATS，不使用内固定器械切除哑铃形肿瘤。对临床资料进行了回顾。
平均随访期为25个月（范围3 - 58个月），手术时间为255至385分钟（平均331分钟），估计失血量为110至930毫升（平均348毫升）。所有病例肿瘤均在未使用内固定器械的情况下完全切除，且术后无脊柱不稳。术后并发症包括1例肺不张和1例面部无汗。
一期后路微创椎板切除术和VATS可能是一种安全且侵入性较小的技术，用于切除胸段哑铃形肿瘤且不会导致脊柱不稳。该方法具有早期活动和快速恢复的优势，因为它减少了失血量和术后疼痛。
