Bonavina L, Pavanello M, Baisi A, Castoro C, Ancona E, Peracchia A
Department of General Surgery and Surgical Oncology, University of Milan, Italy.
Eur J Surg. 1996 Sep;162(9):703-7.
To describe our experience with mediastinal cysts involving the oesophagus.
Retrospective study.
University hospital, Italy.
11 patients who presented to our department with a mediastinal cyst from 1976-1994.
Excision of the mass through a posterolateral thoracotomy (n = 10) or by video-assisted thoracoscopy.
Morbidity and mortality.
8 patients presented with retrosternal or epigastric pain, three of whom had mild dysphagia. In the remaining 3 the tumour was asymptomatic and an incidental finding on a chest radiograph. Endoscopic ultrasonography and computed tomography (CT) allowed preoperative diagnosis of an extramucosal cyst in 5 of the 7 patients investigated by both tests. Masses were excised through a formal thoracotomy (n = 10) or by video-assisted thoracoscopy. Histological examination confirmed a benign cyst in all cases. There was no operative morbidity and nine patients are free of symptoms after a median follow-up of 2.3 years.
Excision, preferably by thoracoscopy, is the treatment of choice for mediastinal cysts that involve the oesophagus. Special attention should be paid to the vagal nerves, and as many as possible of the muscular layers of the oesophagus should be preserved.
描述我们处理累及食管的纵隔囊肿的经验。
回顾性研究。
意大利大学医院。
1976年至1994年间在我院就诊的11例纵隔囊肿患者。
通过后外侧开胸手术切除肿物（n = 10）或通过电视辅助胸腔镜手术切除。
发病率和死亡率。
8例患者表现为胸骨后或上腹部疼痛，其中3例有轻度吞咽困难。其余3例肿瘤无症状，是在胸部X线检查时偶然发现的。在接受内镜超声和计算机断层扫描（CT）检查的7例患者中，有5例通过这两项检查在术前诊断为黏膜外囊肿。肿物通过正规开胸手术（n = 10）或电视辅助胸腔镜手术切除。组织学检查证实所有病例均为良性囊肿。无手术相关并发症，中位随访2.3年后，9例患者无症状。
对于累及食管的纵隔囊肿，首选手术切除，最好通过胸腔镜进行。应特别注意迷走神经，并尽可能保留食管的多层肌肉组织。
