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[纵隔肿瘤的外科治疗现状]

[Current status of surgery for mediastinal tumors].

作者信息

Nakahara K

出版信息

Rinsho Kyobu Geka. 1989 Oct;9(5):429-33.

PMID:9301951
Abstract

Impact of surgery on the result of mediastinal tumors is variable: In benign tumors such as teratoma, congenital cyst, intrathoracic struma and neurogenic tumor, a complete resection causes a good result. Simultaneous thoracotomy and laminectomy should be performed in the Dumbbell type of neurogenic tumor. Since complete resection of the invasive thymoma promises a good prognosis, excision of all the tumor and invading tissues followed by radiation therapy is recommended in the treatment of thymoma. In pure seminoma resection and radiation therapy is the treatment of choice, while in non-seminomatous germ cell tumor, aggressive chemo- and radiation therapy should be performed, until tumor markers such as AFP and HCG become negative. The operation is to be followed afterwards. A mass screening test for neuroblastoma in infant facilitates an early detection of this disease and promises a good result by chemotherapy, radiation therapy, and surgery. There is still a possibility that the result of treatment of the malignant mediastinal tumors would be improved by exact diagnosis and intensive treatment.

摘要

手术对纵隔肿瘤治疗结果的影响各不相同

在畸胎瘤、先天性囊肿、胸内甲状腺肿和神经源性肿瘤等良性肿瘤中,完整切除可取得良好效果。哑铃型神经源性肿瘤应同时行开胸术和椎板切除术。由于侵袭性胸腺瘤的完整切除有望带来良好预后,因此胸腺瘤治疗建议切除所有肿瘤及受侵组织,随后进行放射治疗。对于纯精原细胞瘤,手术切除和放射治疗是首选治疗方法,而对于非精原细胞性生殖细胞瘤,则应进行积极的化疗和放射治疗,直至甲胎蛋白(AFP)和人绒毛膜促性腺激素(HCG)等肿瘤标志物转阴,之后再行手术。婴儿神经母细胞瘤的大规模筛查有助于早期发现该病,通过化疗、放射治疗和手术有望取得良好效果。恶性纵隔肿瘤的治疗结果仍有可能通过准确诊断和强化治疗得到改善。

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