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机器人辅助胸腔镜手术联合胸壁整块切除成功切除纵隔副神经节瘤:一例报告

Mediastinal paraganglioma successfully resected by robot-assisted thoracoscopic surgery with en bloc chest wall resection: a case report.

作者信息

Shidei Hiroaki, Maeda Hideyuki, Isaka Tamami, Matsumoto Takako, Yamamoto Tomoko, Nagashima Yoji, Kanzaki Masato

机构信息

Department of Thoracic Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Department of Surgical Pathology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

出版信息

BMC Surg. 2020 Mar 5;20(1):45. doi: 10.1186/s12893-020-00701-2.

Abstract

BACKGROUND

Robot-assisted thoracoscopic surgery (RATS) is useful for surgery in the apical region of the chest cavity, as it narrows towards the head. Here, we describe a nonfunctional, rib-invasive paraganglioma arising in the posterior mediastinum that was successfully removed using RATS combined with chest wall resection.

CASE PRESENTATION

A 31-year-old woman presented with a posterior mediastinal mass on chest computed tomography (CT) scan during a medical check-up 2 years prior. Positron emission tomography/computed tomography scan with F-18 fluorodeoxyglucose revealed a mass associated with standardized uptake maximum value of 2.69. With a preoperative diagnosis of neurogenic tumor by CT-guided percutaneous fine-needle aspiration biopsy, we performed robot-assisted tumor resection combined with chest wall resection. The wristed instruments of the robotic surgical system have increased range of motion and enabled the tumor resection without organ injury in the thoracic cavity. Histopathology examination revealed a non-functional paraganglioma with rib invasion.

CONCLUSIONS

RATS is a useful technique, enabling safer and easier resection of a mediastinal tumor adjacent to surrounding organs.

摘要

背景

机器人辅助胸腔镜手术(RATS)对于胸腔顶部区域的手术很有用,因为胸腔向头部方向逐渐变窄。在此,我们描述一例发生于后纵隔的无功能、侵犯肋骨的副神经节瘤,该肿瘤通过RATS联合胸壁切除成功切除。

病例介绍

一名31岁女性在2年前体检时胸部计算机断层扫描(CT)发现后纵隔肿块。F-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描显示一个标准化摄取值最大值为2.69的肿块。通过CT引导下经皮细针穿刺活检术前诊断为神经源性肿瘤,我们进行了机器人辅助肿瘤切除联合胸壁切除。机器人手术系统的腕部器械增加了活动范围,能够在胸腔内无器官损伤的情况下切除肿瘤。组织病理学检查显示为侵犯肋骨的无功能副神经节瘤。

结论

RATS是一种有用的技术,能够更安全、更容易地切除与周围器官相邻的纵隔肿瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3959/7057551/74ef3c072f00/12893_2020_701_Fig1_HTML.jpg

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