Wewel Joshua T, Kasliwal Manish K, Chmielewski Gary W, O'Toole John E
Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA.
Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
J Craniovertebr Junction Spine. 2020 Apr-Jun;11(2):148-151. doi: 10.4103/jcvjs.JCVJS_52_20. Epub 2020 Jun 5.
Thoracic dumbbell tumors are relatively uncommon neoplasms that arise from the neurogenic elements. Surgical resection can be challenging as the tumor involves both the spinal canal and thoracic cavity. Historically, thoracotomy and laminectomy were utilized for the resection of these tumors. Although single-stage removal of such tumors has been described recently, there is no prior description of a total minimally invasive single-stage resection of a thoracic dumbbell ganglioneuroma. The current report describes a completely minimally invasive surgical resection for such a tumor performed using the posterior minimally invasive tubular approach to resect the intraspinal component with ligation of the T2 nerve root in conjunction with robotic-assisted thoracoscopic resection of the extraforaminal, intrathoracic component of the tumor. This report illustrates the safety and utility of a completely minimally invasive endoscopic resection of a thoracic dumbbell tumor that can potentially obviate the morbidity associated with open surgical resections for such tumors.
胸段哑铃形肿瘤是起源于神经源性成分的相对罕见的肿瘤。由于肿瘤累及椎管和胸腔，手术切除具有挑战性。历史上，开胸手术和椎板切除术曾用于这些肿瘤的切除。尽管最近有关于此类肿瘤一期切除的描述，但此前尚无关于胸段哑铃形神经节细胞瘤完全微创一期切除的报道。本报告描述了一种针对此类肿瘤的完全微创手术切除方法，即采用后路微创管状入路切除脊髓内成分并结扎T2神经根，同时联合机器人辅助胸腔镜切除肿瘤的椎间孔外、胸腔内成分。本报告说明了胸段哑铃形肿瘤完全微创内镜切除的安全性和实用性，这可能避免此类肿瘤开放手术切除相关的并发症。
