摘要
目的:探讨纵隔囊肿的临床特点、诊断及胸腔镜手术治疗要点。方法:2011年1月至2018年4月行全胸腔镜纵隔囊肿手术切除治疗的32例患者,回顾分析所有患者的临床资料、诊断方法及胸腔镜手术治疗要点。结果:术前CT示病灶位于前纵隔27例,位于中纵隔1例,位于后纵隔4例;病灶最长径(29.83±17.59)mm;平扫CT值(25.03±20.03)HU,增强后CT值(33.10±18.56)HU,增强前后CT值比较差异无统计学意义(t=-1.603,P=0.114)。32例均行胸腔镜手术切除治疗,手术平均时间(104.33±20.51)min,术中出血量(20.15±17.20)ml,无围手术期死亡病例,无中转开放手术病例。术后病理:胸腺囊肿25例,心包囊肿2例,食管囊肿2例,囊性成熟性畸胎瘤、支气管囊肿、囊性神经鞘瘤各1例。32例患者平均随访时间3.2年,无死亡和复发病例。结论:胸腔镜手术是诊断和治疗纵隔囊肿的有效措施,手术安全可靠且具有微创优势。
Objective:To explore the clinical features,diagnosis and thoracoscopic surgery key points of mediastinal cysts.Methods:The clinical data,diagnosis and thoracoscopic surgery key points of 32 mediastinal cysts patients that were treated with totally thoracoscopic surgery from 2011.1 to 2018.4 were retrospectively analyzed.Results:Preoperative CT showed that 27 cysts in anterior mediastinum,1 in middle mediastinum,4 in posterior mediastinum;and the longest diameter of the cysts was(29.83±17.59)mm.The plain scan CT value of cysts was(25.03±20.03)HU,the enhanced CT value was(33.10±18.56)HU.The CT value of cysts in plain and enhanced scans were not statistic different(t=-1.603,P=0.114).All the 32 patients were treated with thoracoscopic surgery,the average operative time was(104.33±20.51)min,the intraoperative blood loss was(20.15±17.20)ml,and no perioperative deaths and no patients of conversion to open surgery.The pathological diagnoses after operation were 25 cases thymic cyst,2 cases pericardial cyst,2 cases esophageal cyst,1 case cystic mature teratoma,1 case bronchial cyst and 1 case cystic schwannoma.The mean follow-up time of 32 patients was 3.2 years,and no deaths and recurrent cases.Conclusions:Thoracoscopic surgery is an effective method for diagnosing and treating of mediastinal cyst,and has the advantages of safety,reliability and minimal invasiveness.
作者
朱勇
施舜缤
张林
王海龙
钱涛涛
ZHU Yong;SHI Shun-bin;ZHANG Lin(Department of Thoracic Surgery,the First People’s Hospital of Wujiang District,Jiangsu Suzhou 215200,China)
出处
《承德医学院学报》
2019年第4期288-290,共3页
Journal of Chengde Medical University
关键词
纵隔囊肿
诊断
全胸腔镜手术
临床分析
Mediastinal cyst
Diagnosis
Totally thoracoscopic surgery
Clinical analysis
