摘要
目的 探讨复杂纵隔肿瘤的手术治疗效果.方法 回顾性分析2016-06—2019-06间连云港市第二人民医院胸外科收治的24例复杂纵隔肿瘤患者的临床和随访资料.24例患者均在气管插管全麻下手术.胸骨正中切口9例,前外侧切口6例,后外侧切口6例,半蚌壳切口2例,颈横切口1例.根治性切除22例,姑息性切除2例.合并肺部分切除4例,心包部分切除5例,膈肌部分切除1例,左无名静脉及上腔静脉成形或置换4例.结果 24例患者均顺利完成手术.术后发生复张性肺水肿1例,心律失常5例,喉返神经损伤致声音嘶哑1例,心包积液2例,胸腔积液4例.3例合并重症肌无力的患者术后肌无力症状均有不同程度缓解,未发生肌无力危象.术中、术后均未发生其他严重并发症,患者均痊愈出院.1例纵隔精原细胞瘤的患者术后行辅助化疗,半年内死于肿瘤全身多发转移.结论 手术是复杂纵隔肿瘤首选治疗方法,术前充分评估肿瘤的可切除性,严格把握手术指征,选择相应的切口、合理的手术方法和娴熟的技巧,可获得良好的手术效果.
Objective To summarize the experiences of treating complicated mediastinal tumors.Methods The clinical materials of 24 patients with complicated mediastinal tumors were reviewed.All the 24 patients were operated under general anesthesia with endotracheal intubation.Nine Mid-sternal incisions,6 anterolateral incisioins,6 posterolateral incisions,2 Hemi-clamshell incisions,1 neck transverse incision.22 patients underwent radical resection and 2 patients received palliative resection.4 partial pulmonary resections, 5 partial pericardiectomies,1 partial diaphragmatic resections,4 angioplasties or vascular replacements.Results All 24 patients successfully completed the operation. There were 1 case of recurrent pulmonary edema,5 cases of arrhythmia,1 case of hoarseness caused by recurrent laryngeal nerve injury,2 cases of pericardial effusion and 4 cases of pleural effusion. The symptoms of myasthenia gravis were relieved in 3 cases with myasthenia gravis. No other serious complications occurred during and after operation, and the patients were cured and discharged. One case of mediastinal seminoma was treated with adjuvant chemotherapy and died of multiple metastasis within half a year.Conclusion Surgery is the first choice for the treatment of complex mediastinal tumors. It can fully evaluate the resectability of tumors before operation, strictly grasp the surgical indications, select the corresponding incision, reasonable surgical methods and proficient skills, and obtain good surgical results.
作者
赵澜涛
王亮
王永宏
Zhao Lantao;Wang Liang;Wang Yonghong(Department of Thoracic Surger of the Second People's Hospital(Oncology Hospital),lianyungang Jiangsu 222006,China)
出处
《河南外科学杂志》
2020年第6期15-17,共3页
Henan Journal of Surgery
关键词
复杂纵隔肿瘤
手术
恶性
Complicated mediastinal tumor
Surgery
Malignant
