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纵隔成熟畸胎瘤的手术结果

Surgical outcomes in mediastinal mature teratoma.

作者信息

Pulle Mohan Venkatesh, Bhan Anmol, Bishnoi Sukhram, Asaf Belal Bin, Puri Harsh Vardhan, Bangeria Sumit, Parikh Manan Bharatkumar, Kumar Arvind

机构信息

Institute of Chest Surgery, Medanta, Gurugram India.

Dayanand Medical College, Ludhiana, Punjab India.

出版信息

Indian J Thorac Cardiovasc Surg. 2025 May;41(5):541-551. doi: 10.1007/s12055-024-01882-8. Epub 2025 Jan 18.

Abstract

BACKGROUND

This study was aimed at reporting the clinical characteristics and perioperative surgical outcomes of mediastinal mature teratoma managed in a single surgical unit.

METHODS

This is a retrospective analysis of 35 cases of mediastinal mature teratoma cases managed in a tertiary level thoracic surgery center over 10 years. A comprehensive analysis of perioperative surgical outcomes including complications was performed.

RESULTS

Males ( = 22, 62.8%) were predominant in the study group. Mean age of the cohort was 31.2 ± 13.3 years. The diagnosis was unruptured mature teratoma in 17(48.6%), ruptured mature teratoma in 8 (22.8%) and mature cystic teratoma in 10 (28.6%) patients. The mean duration from symptoms was 5.5 months (range: 1 - 84 months). Open surgery was done in 22 patients (62.8%) followed by video-assisted thoracoscopic surgery in 4 (11.4%) and robotic surgery in 9 patients (25.7%). Conversion from minimal access surgery to open surgery was in 2 patients (5.7%). The mean duration of intercostal chest drainage (ICD) was 6.3 ± 1.3 days, and mean hospital stay averaged 5.8 ± 2.7 days. Most common postoperative complication was prolonged post-operative air leak (> 7 days) in 5 patients (14.3%). The peri-operative mortality was in 1 (2.8%) patient. Ruptured teratoma was a strong predictor of postoperative complications ( = 0.008).

CONCLUSION

Complete surgical resection is primary and effective treatment modality for mediastinal mature teratoma. A tailored approach is needed, considering the factors like tumor size, location, and relation with surrounding structures.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12055-024-01882-8.

摘要

背景

本研究旨在报告在单一手术单元中治疗的纵隔成熟畸胎瘤的临床特征和围手术期手术结果。

方法

这是一项对一家三级胸外科中心10年间治疗的35例纵隔成熟畸胎瘤病例的回顾性分析。对围手术期手术结果(包括并发症)进行了全面分析。

结果

研究组中男性占主导(n = 22,62.8%)。队列的平均年龄为31.2±13.3岁。诊断为未破裂成熟畸胎瘤的有17例(48.6%),破裂成熟畸胎瘤的有8例(22.8%),成熟囊性畸胎瘤的有10例(28.6%)。从出现症状到确诊的平均时长为5.5个月(范围:1 - 84个月)。22例患者(62.8%)接受了开放手术,4例(11.4%)接受了电视辅助胸腔镜手术,9例患者(25.7%)接受了机器人手术。2例患者(5.7%)从微创手术转为开放手术。肋间胸腔引流(ICD)的平均时长为6.3±1.3天,平均住院时间为5.8±2.7天。最常见的术后并发症是术后持续漏气(>7天),共5例患者(14.3%)。围手术期死亡率为1例患者(2.8%)。破裂的畸胎瘤是术后并发症的有力预测指标(P = 0.008)。

结论

完整的手术切除是纵隔成熟畸胎瘤的主要且有效治疗方式。需要根据肿瘤大小、位置以及与周围结构的关系等因素采取量身定制的方法。

补充信息

在线版本包含可在10.1007/s12055-024-01882-8获取的补充材料。

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本文引用的文献

5
Minimally invasive mediastinal surgery.微创纵隔手术
Ann Cardiothorac Surg. 2016 Jan;5(1):10-7. doi: 10.3978/j.issn.2225-319X.2015.12.03.

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