巨大前纵隔肿瘤手术应用改良半蛤壳式切口的疗效及安全性评估(1)
【摘要】 目的：評估改良半蛤壳式切口治疗巨大前纵隔肿瘤中的临床疗效及安全性。方法：选取2011年
1月-2016年12月采用改良半蛤壳式切口治疗巨大前纵隔肿瘤患者26例，于患侧的第3或第4肋间的锁骨中线处至对侧胸骨旁线处做一横断胸骨的切口，行前纵隔肿瘤根治术或姑息性减瘤术，术毕胸骨以细钢丝给予单纯的缝合固定，并对患者进行随访。结果：26例患者中行肿瘤根治切除术16例，肿瘤大小10.8 cm×8.3 cm～17.2 cm×9.0 cm；行姑息性减瘤术10例，肿瘤大小11.6 cm×7.9 cm～21.0 cm×9.0 cm；
因肿瘤周围的组织受累术中行扩大切除术者15例。全组无发生围手术期及手术相关的死亡患者，仅1例胸腺瘤合并重症肌无力患者在术后发生一过性的肌无力危象，其余均未发生严重的手术并发症。随访6～62个月，良性患者的术后生存时间为11～62个月，而恶性患者的术后生存时间为6～55个月。结论：改良半蛤壳式的手术切口治疗巨大前纵隔肿瘤其操作简单快捷，对前纵隔的结构显露良好，且术后并发症少，治疗结果安全有效，可在基层进行推广。
, 百拇医药
【关键词】 巨大纵隔肿瘤； 改良术式； 半蛤壳式切口
Evaluation of Efficacy and Safety of Modified Hemi-clamshell Approach for Giant Anterior Mediastinal Tumor/LI Guanran，FANG Yuan，WANG Yang，et al.//Medical Innovation of China，2018，15(01)：106-109
【Abstract】 Objective：To evaluate the clinical efficacy and safety of modified Hemi-clamshell Approach in treatment of giant anterior mediastinal tumors.Method：26 patients with giant anterior mediastinal tumors were treated with modified Hemi-clamshell Approach from January 2011 to December 2016 were selected.The midclavicular line in a side of the third or fourth intercostal to the contralateral parasternal line at a median sternotomy incision，anterior mediastinal tumor resection or palliative cytoreductive surgery，at the end of the operation，the simple suture of the sternum was given with fine wire，and follow-up on patients.Result：16 cases of radical resection of tumor were performed in 26 patients，the size of the tumor was 0.8 cm×8.3 cm-17.2 cm×9.0 cm，10 cases of palliative reduction of tumor，the size of the tumor was 11.6 cm×7.9 cm-21.0 cm×9.0 cm，15 cases of enlarged excision were performed in the operation of tissue involvement around the tumor.No perioperative and operative related death occurred in the whole group.Only 1 patient with thymoma and myasthenia gravis had an excessive myasthenia crisis after operation，and no serious surgical complications were found in other patients.After 6-62 months of follow-up，the survival time of the benign patients was 11-62 months，and the postoperative survival time of the malignant patients was 6-55 months.Conclusion：Modified Hemi-clamshell approach for the treatment of giant anterior mediastinal tumors is simple and quick，the structure of the anterior mediastinum is well revealed，the postoperative complications are few，the treatment results are safe and effective，and can be popularized at the grass-roots level.
【Key words】 Mediastinal tumor； Modified surgery； Hemi-clamshell incision, 百拇医药(李冠燃 方原 汪洋 张庆华)
1月-2016年12月采用改良半蛤壳式切口治疗巨大前纵隔肿瘤患者26例，于患侧的第3或第4肋间的锁骨中线处至对侧胸骨旁线处做一横断胸骨的切口，行前纵隔肿瘤根治术或姑息性减瘤术，术毕胸骨以细钢丝给予单纯的缝合固定，并对患者进行随访。结果：26例患者中行肿瘤根治切除术16例，肿瘤大小10.8 cm×8.3 cm～17.2 cm×9.0 cm；行姑息性减瘤术10例，肿瘤大小11.6 cm×7.9 cm～21.0 cm×9.0 cm；
因肿瘤周围的组织受累术中行扩大切除术者15例。全组无发生围手术期及手术相关的死亡患者，仅1例胸腺瘤合并重症肌无力患者在术后发生一过性的肌无力危象，其余均未发生严重的手术并发症。随访6～62个月，良性患者的术后生存时间为11～62个月，而恶性患者的术后生存时间为6～55个月。结论：改良半蛤壳式的手术切口治疗巨大前纵隔肿瘤其操作简单快捷，对前纵隔的结构显露良好，且术后并发症少，治疗结果安全有效，可在基层进行推广。
, 百拇医药
【关键词】 巨大纵隔肿瘤； 改良术式； 半蛤壳式切口
Evaluation of Efficacy and Safety of Modified Hemi-clamshell Approach for Giant Anterior Mediastinal Tumor/LI Guanran，FANG Yuan，WANG Yang，et al.//Medical Innovation of China，2018，15(01)：106-109
【Abstract】 Objective：To evaluate the clinical efficacy and safety of modified Hemi-clamshell Approach in treatment of giant anterior mediastinal tumors.Method：26 patients with giant anterior mediastinal tumors were treated with modified Hemi-clamshell Approach from January 2011 to December 2016 were selected.The midclavicular line in a side of the third or fourth intercostal to the contralateral parasternal line at a median sternotomy incision，anterior mediastinal tumor resection or palliative cytoreductive surgery，at the end of the operation，the simple suture of the sternum was given with fine wire，and follow-up on patients.Result：16 cases of radical resection of tumor were performed in 26 patients，the size of the tumor was 0.8 cm×8.3 cm-17.2 cm×9.0 cm，10 cases of palliative reduction of tumor，the size of the tumor was 11.6 cm×7.9 cm-21.0 cm×9.0 cm，15 cases of enlarged excision were performed in the operation of tissue involvement around the tumor.No perioperative and operative related death occurred in the whole group.Only 1 patient with thymoma and myasthenia gravis had an excessive myasthenia crisis after operation，and no serious surgical complications were found in other patients.After 6-62 months of follow-up，the survival time of the benign patients was 11-62 months，and the postoperative survival time of the malignant patients was 6-55 months.Conclusion：Modified Hemi-clamshell approach for the treatment of giant anterior mediastinal tumors is simple and quick，the structure of the anterior mediastinum is well revealed，the postoperative complications are few，the treatment results are safe and effective，and can be popularized at the grass-roots level.
【Key words】 Mediastinal tumor； Modified surgery； Hemi-clamshell incision, 百拇医药(李冠燃 方原 汪洋 张庆华)
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