Pacchiarotti Giacomo, Wang Michael Y, Kolcun John Paul G, Chang Ken Hsuan-Kan, Al Maaieh Motasem, Reis Victor S, Nguyen Dao M
Institute of Neurosurgery, University of Rome "La Sapienza," Rome, Italy; and.
Departments of Neurological Surgery and.
Neurosurg Focus. 2017 May;42(5):E17. doi: 10.3171/2017.2.FOCUS16551.
Solitary paravertebral schwannomas in the thoracic spine and lacking an intraspinal component are uncommon. These benign nerve sheath tumors are typically treated using complete resection with an excellent outcome. Resection of these tumors is achieved by an anterior approach via open thoracotomy or minimally invasive thoracoscopy, by a posterior approach via laminectomy, or by a combination of both approaches. These tumors most commonly occur in the midthoracic region, for which surgical removal is usually straightforward. The authors of this report describe 2 cases of paravertebral schwannoma at extreme locations of the posterior mediastinum, one at the superior sulcus and the other at the inferior sulcus of the thoracic cavity, for which the usual surgical approaches for safe resection can be challenging. The tumors were completely resected with robot-assisted thoracoscopic surgery. This report suggests that single-stage anterior surgery for this type of tumor in extreme locations is safe and effective with this novel minimally invasive technique.
孤立性胸椎旁神经鞘瘤且无脊髓内成分者并不常见。这些良性神经鞘瘤通常采用完整切除治疗,效果良好。这些肿瘤的切除可通过开胸手术或微创胸腔镜的前路、椎板切除术的后路或两种方法联合进行。这些肿瘤最常发生在胸段中部,通常手术切除较为简单。本报告的作者描述了2例位于后纵隔极端位置的胸椎旁神经鞘瘤,1例位于胸腔上沟,另1例位于胸腔下沟,对于这些部位,通常安全切除的手术方法具有挑战性。肿瘤通过机器人辅助胸腔镜手术被完整切除。本报告表明,对于此类位于极端位置的肿瘤,采用这种新型微创技术进行单阶段前路手术是安全有效的。