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目的探讨单操作孔胸腔镜在纵隔肿瘤治疗中的临床应用价值。方法回顾性分析我科2012年至3月至2014年3月我院胸外科采用单操作孔胸腔镜切除纵隔肿瘤18例的临床资料,男11例、女7例,年龄45.5(30~55)岁。胸腺瘤12例,胸腺瘤合并重症肌无力3例,胸腺囊肿4例,畸胎瘤2例。结果所有患者均在胸腔镜下或胸腔镜辅助下完成,其中16例采用单操作孔胸腔镜下操作,其中有1例因术中出血,延长操作孔切口,完成止血,另有1例因肿瘤直径约8 cm,合并胸膜腔部分粘连,增加一副操作孔完成。术中操作时间80(40~120)min,术中出血量100(50~300)ml,术后胸腔引流管留置时间3(2~5)d,住院时间6(4~8)d,均未出现严重并发症。术后随访18例患者1个月至2年,均未见肿瘤复发,其中合并重症肌无力的3例患者,术后肌无力均消失。结论单操作孔胸腔镜治疗前纵隔肿瘤是安全有效且可行的。
Objective To investigate the clinical value of single-hole thoracoscope in the treatment of mediastinal tumors. Methods The clinical data of 18 patients with mediastinal tumors excised by thoracoscope with single-operation hole in our hospital from 2012 to March to March 2014 were retrospectively analyzed. There were 11 males and 7 females, aged 45.5 (30-55) year old. Thymoma in 12 cases, thymoma with myasthenia gravis in 3 cases, thymus cyst in 4 cases and teratoma in 2 cases. Results All patients underwent thoracoscopic or thoracoscopic assisted surgery. Sixteen patients underwent thoracoscope operation with a single operation hole. Among them, one patient underwent hemostasis due to intraoperative hemorrhage and hemostasis was completed. In another case, Diameter of about 8 cm, combined pleural cavity adhesion, an increase of an operation hole to complete. The operative time was 80 (40-120) min, the intraoperative blood loss was 100 (50-300) ml, the postoperative thoracic drainage tube placement time was 3 (2-5) d and the length of stay was 6 (4-8) d No serious complications occurred. 18 patients were followed up from 1 month to 2 years, no tumor recurrence, including 3 patients with myasthenia gravis, muscle weakness disappeared. Conclusion Single-hole thoracoscopic treatment of anterior mediastinum tumor is safe, effective and feasible.