Kuo Yi-Hsuan, Hsu Po-Kuei, Wu Jau-Ching, Huang Wen-Cheng, Tu Tsung-Hsi
Department of Neurosurgery, Neurological Institute.
School of Medicine and.
J Neurosurg Case Lessons. 2021 Jun 7;1(23):CASE2065. doi: 10.3171/CASE2065.
Pancoast tumors are a wide range of tumors located in the apex of the lung. Traditional surgery for Pancoast neurogenic tumors frequently involves extensive approaches, whether anterior or posterior or a combination, in which osteotomies are sometimes required. In this study, the authors proposed a less invasive surgical strategy using the standard Cloward's approach for complete resection of a schwannoma arising from the T1 nerve root.
Two patients, each harboring a large T1 tumor, one on each side, underwent Cloward's approach with and without thoracoscopic surgery. Both patients had complete resection of the tumor. Considering the benign and encapsulated nature of neurogenic tumors, Cloward's approach under neuromonitoring, which is a common procedure for anterior cervical discectomy for most neurosurgeons, is a safe and less invasive alternative for Pancoast neurogenic tumors. For patients whose tumor cannot be removed completely via Cloward's approach, video-assisted thoracoscopic surgery is a viable backup plan with minimal invasiveness.
Cloward's approach is a viable option for Pancoast neurogenic tumors.
肺上沟瘤是位于肺尖的多种肿瘤。对于肺上沟神经源性肿瘤，传统手术通常需要广泛的手术入路，无论是前路、后路或联合入路，有时还需要进行截骨术。在本研究中，作者提出了一种微创外科策略，即采用标准的克洛德（Cloward）入路完整切除起源于T1神经根的神经鞘瘤。
两名患者，每侧各有一个巨大的T1肿瘤，分别接受了有无胸腔镜辅助的克洛德入路手术。两名患者的肿瘤均被完整切除。考虑到神经源性肿瘤的良性和包膜性，在神经监测下采用克洛德入路，这对大多数神经外科医生来说是一种常见的颈椎前路椎间盘切除术操作，是肺上沟神经源性肿瘤安全且微创的替代方法。对于无法通过克洛德入路完全切除肿瘤的患者，电视辅助胸腔镜手术是一种微创的可行备用方案。
克洛德入路是治疗肺上沟神经源性肿瘤的可行选择。
