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后纵隔神经源性肿瘤的胸腔镜治疗

Thoracoscopic management of posterior mediastinal neurogenic tumours.

作者信息

Bishnoi Sukhram, Asaf Belal Bin, Puri Harsh Vardhan, Pulle Mohan Venkatesh, Parikh Manan Bharatkumar, Kumar Reena, Kumar Arvind

机构信息

Centre for Chest Surgery, Sir Ganga Ram Hospital, New Delhi, India.

出版信息

J Minim Access Surg. 2022 Jul-Sep;18(3):366-371. doi: 10.4103/jmas.JMAS_234_20.

Abstract

BACKGROUND

This study describes the surgical technique of thoracoscopic resection of posterior mediastinal neurogenic tumours and reporting the surgical outcomes.

METHODS

This is a retrospective analysis of 21 patients operated over 7 years in a dedicated thoracic surgery centre. The demographic and post-operative parameters along with complications were recorded and analysed.

RESULTS

Twelve patients had right-sided tumours, while 9 had left-sided lesions, and 9 were on the left side. The most common diagnosis was schwannoma (n = 15, 71.42%), followed by neurofibroma (n = 4, 19.04%). The average surgery duration was 104 min (85-135 min), and the mean blood loss was 120 ml (25 ml-250 ml). The average lesion size was 4.8 cm (2 cm-7 cm). Conversion to open procedure was required in one patient. Two patients (14.2%) developed complications. One patient developed Horner's Syndrome and the other developed post-operative lung atelectasis. The median follow-up was 36 months (6-90 months). No recurrence was observed during the follow-up period.

CONCLUSIONS

Thoracoscopic approach to posterior mediastinal neurogenic tumours is feasible and allows for low morbidity, short hospital stay and superior cosmesis.

摘要

背景

本研究描述了胸腔镜切除后纵隔神经源性肿瘤的手术技术并报告了手术结果。

方法

这是一项对在一个专门的胸外科中心7年内接受手术的21例患者的回顾性分析。记录并分析了人口统计学和术后参数以及并发症情况。

结果

12例患者为右侧肿瘤,9例为左侧病变。最常见的诊断是神经鞘瘤(n = 15,71.42%),其次是神经纤维瘤(n = 4,19.04%)。平均手术时间为104分钟(85 - 135分钟),平均失血量为120毫升(25毫升 - 250毫升)。平均病变大小为4.8厘米(2厘米 - 7厘米)。1例患者需要转为开放手术。2例患者(14.2%)出现并发症。1例患者出现霍纳综合征,另1例出现术后肺不张。中位随访时间为36个月(6 - 90个月)。随访期间未观察到复发。

结论

胸腔镜治疗后纵隔神经源性肿瘤是可行的,且发病率低、住院时间短、美容效果好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2553/9306111/98f9368072d5/JMAS-18-366-g001.jpg

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