胸腺囊肿的诊断及全胸腔镜手术治疗:附72例报告

发布时间：2018-05-15 11:13

  本文选题：胸腺囊肿 + 纵隔囊肿　； 参考：《中国微创外科杂志》2017年05期

【摘要】：目的探讨胸腺囊肿的临床特点及胸腔镜手术价值。方法 2001年4月~2012年10月对72例胸腺囊肿施行胸腔镜手术,置入胸腔镜后采用电凝钩与钝头吸引器游离囊肿,辅以钛夹或超声刀处理囊肿蒂部,根据术中情况决定切除范围。结果 CT诊断胸腺囊肿比例51.4%(37/72),其中直径3 cm组与直径≤3 cm组分别为70.5%(31/44)和21.4%(6/28),有统计学差异(χ~2=16.464,P=0.000);囊液清亮者(n=28)与囊液黏稠者(n=14)分别为67.9%(19/28)和21.4%(3/14),有统计学差异(χ~2=8.066,P=0.005)。全胸腔镜手术71例,因囊肿与周围肺组织致密粘连影响探查及分离中转开胸1例(1.4%)。手术方式包括:胸腺囊肿+胸腺切除术31例,胸腺囊肿+部分胸腺切除术21例,胸腺扩大切除术10例,单纯胸腺囊肿切除术10例,术后无严重并发症或死亡。手术时间(113.1±43.5)min;出血量中位数50.0 ml(5~250 ml)。随访成功率83.3%(60/72),中位随访时间47个月(24~150个月),均未见囊肿复发。结论胸腺囊肿的直径、囊液性质是影响CT诊断准确率的重要因素;胸腔镜手术安全、有效,具有微创优势,切除范围需要根据症状、影像学、术中探查情况和手术切除彻底性综合考虑。
[Abstract]:Objective to investigate the clinical features of thymic cysts and the value of thoracoscopic surgery. Methods from April 2001 to October 2012, 72 cases of thymic cysts underwent thoracoscopic surgery. The cysts were treated by electrocoagulation hook and blunt head attractor, and the pedicle of the cyst was treated with titanium clip or ultrasonic knife. The range of resection was determined according to the operation conditions. Results the proportion of thymic cysts diagnosed by CT was 51.4 / 37 / 72, and the diameter of 3 cm group and 鈮，

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