摘要
目的探讨应用电视纵隔镜行肺癌分期和纵隔疑难疾病诊断的价值和围手术期并发症的预防。方法回顾分析我院行纵隔镜检查的63例患者,其中颈部纵隔镜术58例,胸骨旁纵隔镜术5例,手术均在全麻下完成,单纯纵隔肺门疑难疾病48例,高度怀疑肺癌或诊断为非小细胞肺癌伴有纵隔淋巴结肿大的患者15例。结果15例怀疑或已确诊为肺癌患者,淋巴结病理阳性率为60.0%(9/15),CMS病理假阴性率16.7%(1/6)。48例纵隔疑难疾病患者,47例获得病理诊断,1例临床证实,经验性治疗肿块明显缩小,疾病确诊率98%(47/48)。无手术死亡,1例大出血保守治疗成功。无其他相关的术后并发症。结论纵隔镜技术安全有效,对明确肺癌的分期和诊断纵隔疑难疾病检查准确率高。
Objective To evaluate the role of videomediastinoscopy in the diagnosis of disease of the mediastinum and staging of lung cancer and prevention of perioperative complications. Methods We retrospectively reviewed the clinical records of 63 patients who underwent videomediastinoscopy. General anesthesia was employed. The operation consisted of cervical videomediastinoscopy in 58 patients, parasternal videomediastinoseopy in 5 patients. 48 patients had videomediastinoscopy for diagnosis of isolated mediastinal mass or lymphadenopathy, 15 patients with non small cell lung cancer or suspected lung cancer showed enlarged mediastinal lymph nodes radiographically in the chest. Results 15 cases suspected or confirmed as lung cancer,of which lymphatic nodes positive rate was 60. 0% (9/ 15 ) and false negative rate by CMS was 16. 7% (1/6). 47 among 48 cases mediastinal masses confirmed the diagnosis. No perioperative death and other major complications occurred. Conservative management of 1 case of major hemorrhage succeeded. Conclusion Videomediastinoscopy is a safe and effective procedure for the diagnosis of mediastinal disease and the staging of lung cancer.
出处
《临床肺科杂志》
2009年第10期1297-1298,共2页
Journal of Clinical Pulmonary Medicine
基金
深圳市科技局重点课题(课题编号:200621
200815)
关键词
电视纵隔镜
胸骨旁纵隔镜
胸部疾病
诊断
肺癌分期
大出血
video-mediastinoscopy
parasternal mediastinoscopy
thoracic disease
diagnosis
lung cancer staging
major Hemorrhage