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胸腔镜手术治疗小儿纵隔神经源性肿瘤的单中心研究。

A single-center study of thoracoscopic surgery in the treatment of pediatric mediastinal neurogenic tumors.

机构信息

Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Thoracic Surgery Department, Children's Hospital Capital Institute of Pediatrics, Beijing, China.

出版信息

Thorac Cancer. 2023 Jan;14(1):44-51. doi: 10.1111/1759-7714.14708. Epub 2022 Nov 9.

Abstract

OBJECTIVE

To study the feasibility, safety, and efficacy of thoracoscopic surgery in the treatment of pediatric mediastinal neurogenic tumors, and summarize the treatment experiences and surgical skills.

METHODS

A single-center retrospective analysis of 37 patients with pediatric mediastinal neurogenic tumors was conducted. Clinical charactersistics and postoperative complications were all analyzed.

RESULTS

All the operations were successfully completed. There was no statistically significant difference in tumor diameter between the two groups (p > 0.05). The open surgery group had an average operation time of 96.5 ± 32.38 min, while the thoracoscopic surgery group had an average operation time of 78.3 ± 24.51 min (p < 0.05). The thoracoscopic surgery group had significantly lower intraoperative blood loss than the open surgery group (p < 0.05). In addition, the duration of the postoperative thoracic drainage tube was 5.43 ± 0.76 days in the open surgery group, which was longer than the 2.38 ± 0.87 days in the thoracoscopic surgery group (p < 0.05). Furthermore, the postoperative length of hospital stay was an average of 10.23 ± 1.43 days for the open surgery group, longer than for the thoracoscopic surgery group (4.36 ± 0.87 days) (p < 0.05).

CONCLUSIONS

Thoracoscopic surgery has several advantages in the treatment of pediatric mediastinal neurogenic tumors and is worthy of clinical popularization and application. For giant mediastinal malignant neurogenic tumors, puncture biopsy and adjuvant chemotherapy can be performed before surgery to lessen the tumor volume and enlarge the operation space, which would reduce bleeding and complications.

摘要

目的

探讨胸腔镜手术治疗小儿纵隔神经源性肿瘤的可行性、安全性和有效性,并总结治疗经验和手术技巧。

方法

回顾性分析单中心 37 例小儿纵隔神经源性肿瘤患者的临床资料,分析其临床特征及术后并发症。

结果

所有手术均顺利完成,两组肿瘤直径比较,差异无统计学意义(p>0.05)。开胸组手术时间平均为 96.5±32.38 min,胸腔镜组手术时间平均为 78.3±24.51 min,差异有统计学意义(p<0.05)。胸腔镜组术中出血量明显少于开胸组(p<0.05)。此外,开胸组术后胸腔引流管留置时间为 5.43±0.76 d,长于胸腔镜组的 2.38±0.87 d(p<0.05)。开胸组术后住院时间平均为 10.23±1.43 d,长于胸腔镜组的 4.36±0.87 d(p<0.05)。

结论

胸腔镜手术治疗小儿纵隔神经源性肿瘤具有一定优势,值得临床推广应用。对于巨大纵隔恶性神经源性肿瘤,术前可行穿刺活检及辅助化疗,缩小肿瘤体积,扩大手术空间,以减少术中出血及并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43c4/9807445/ca37a3f82e6b/TCA-14-44-g003.jpg

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