Watanabe M, Takagi K, Aoki T, Ogata T, Tanaka S
Department of Surgery II, National Defense Medical College, Saitama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Jul;42(7):1016-20.
Thoracoscopic surgery was performed in nine patients with benign mediastinal tumors: four neurogenic tumors, three bronchogenic cysts, a foregut cyst and a mature teratoma. Four cystic masses located in para-esophageal lesion in inferior mediastinum and four neurogenic tumors located in posterior mediastinum. A mature teratoma was adjacent to thymus in anterior mediastinum. Under general anesthesia with unilateral ventilation, the patients were turned in the lateral decubitus position and we tilt the operative table to allow gravity assistance for the displacement of the lung. A rigid telescope was inserted through a thracoport. Masses were resected using the dissecting scissors with electric cautery through two other thracoports. Thoracoscopic complete resections were performed in eight patients. In one case that was suspected of malignant tumor by preoperative evaluation, thoracoscopic tumor biopsy was performed and diagnosed as a benign neurogenic tumor during operation histopathologically. But it was resected by thoracotomy, because of its larger size (8 cm in diameter). The average operation time was 122 minutes ranging from 80 to 184 minutes in 8 patients with thoracoscopic resection. No patient has a complication resulting from the thoracoscopic surgery. The chest drainage tubes were removed on 1 or 2-POD in all cases and the average length of postoperative hospitalization was 5.3 days ranging from 4 to 9 days. The thoracoscopic resection for benign mediastinal tumors is minimally invasive and effective procedure compared with classical thoracotomy operation.
对9例纵隔良性肿瘤患者实施了胸腔镜手术：4例神经源性肿瘤、3例支气管囊肿、1例前肠囊肿和1例成熟畸胎瘤。4个囊性肿物位于纵隔下部食管旁病变处，4例神经源性肿瘤位于后纵隔。1例成熟畸胎瘤位于前纵隔，与胸腺相邻。在单侧通气全身麻醉下，患者取侧卧位，我们倾斜手术台以利用重力辅助肺的移位。通过一个胸壁端口插入硬式望远镜。通过另外两个胸壁端口，使用带电灼的解剖剪切除肿物。8例患者实施了胸腔镜完整切除。1例术前评估怀疑为恶性肿瘤的患者，实施了胸腔镜肿瘤活检，术中病理诊断为良性神经源性肿瘤。但因其体积较大（直径8 cm），通过开胸手术将其切除。8例胸腔镜切除患者的平均手术时间为122分钟，范围为80至184分钟。无患者因胸腔镜手术出现并发症。所有病例均在术后第1或2天拔除胸腔引流管，术后平均住院时间为5.3天，范围为4至9天。与传统开胸手术相比，胸腔镜切除纵隔良性肿瘤是一种微创且有效的手术方法。
