Chen L, Ping Y, Zhang H
Department of Thoracic surgery, 4th Hospital, Hebei Medical University, Shijiazhuang.
Zhonghua Zhong Liu Za Zhi. 1996 Nov;18(6):448-50.
The experience on the diagnosis and treatment of 140 cases of giant mediastinal tumors from Jan. 1978 to Dec. 1994 was summarized in this paper. The mean size of the tumors was 14.6 cm x 11.2 cm x 8.9 cm. Among the 140 cases, teratoma was seen in 58 cases (41.4%), thymoma in 32 cases (22.9%) and neurogenic tumors in 16 cases (11.4%). Correct preoperative diagnosis was made in 96.4% for ultrasongraphy (UG), 89.5% for CT and only 19.5% for thin needle biopsy (TNB). The resection rate was 82.9% (116/140) and the operative mortality was 2.14% (3/140). The authors suggest that for the giant mediastinal tumoor, besides chest X-ray, UG and chest CT should be the main preoperative diagnostic nethods, TNB and fibro-optic bronchoscopy are also helpful to define the border and the invasiveness of the tumor. The choice of incisions and attentions during the operation are discussed.
本文总结了1978年1月至1994年12月间140例巨大纵隔肿瘤的诊治经验。肿瘤平均大小为14.6 cm×11.2 cm×8.9 cm。140例中，畸胎瘤58例（41.4%），胸腺瘤32例（22.9%），神经源性肿瘤16例（11.4%）。超声检查（UG）术前正确诊断率为96.4%，CT为89.5%，细针穿刺活检（TNB）仅为19.5%。切除率为82.9%（116/140），手术死亡率为2.14%（3/140）。作者认为，对于巨大纵隔肿瘤，除胸部X线外，UG和胸部CT应作为主要的术前诊断方法，TNB和纤维支气管镜检查也有助于明确肿瘤边界及浸润情况。文中还讨论了手术切口的选择及术中注意事项。
