纵隔囊肿诊断及全胸腔镜手术治疗32例临床分析

承德医学院学报 ›› 2019, Vol. 36 ›› Issue (4): 288-290.

纵隔囊肿诊断及全胸腔镜手术治疗32例临床分析

朱勇, 施舜缤, 张林, 王海龙, 钱涛涛^△

苏州市吴江区第一人民医院胸外科,江苏苏州 215200

收稿日期:2019-02-20 出版日期:2019-08-10 发布日期:2021-11-18
通讯作者: △

CLINICAL ANALYSIS OF DIAGNOSING AND TOTAL THORACOSCOPIC SURGERY FOR MEDIASTINAL CYSTS OF 32 CASES

<a href="http://tougao.cdmc.edu.cn:8088/EN/article/advancedSearchResult.do?searchSQL=(((ZHU Yong[Author]) AND 1[Journal]) AND year[Order])" target="_blank">ZHU Yong</a>,<a href="http://tougao.cdmc.edu.cn:8088/EN/article/advancedSearchResult.do?searchSQL=((( SHI Shun-bin[Author]) AND 1[Journal]) AND year[Order])" target="_blank"> SHI Shun-bin</a>,<a href="http://tougao.cdmc.edu.cn:8088/EN/article/advancedSearchResult.do?searchSQL=((( ZHANG Lin[Author]) AND 1[Journal]) AND year[Order])" target="_blank"> ZHANG Lin</a>,<a href="http://tougao.cdmc.edu.cn:8088/EN/article/advancedSearchResult.do?searchSQL=((( et al[Author]) AND 1[Journal]) AND year[Order])" target="_blank"> et al</a>

Department of Thoracic Surgery, the First People's Hospital of Wujiang District, Jiangsu Suzhou 215200,China

Received:2019-02-20 Online:2019-08-10 Published:2021-11-18

摘要/Abstract

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。

关键词: 纵隔囊肿, 诊断, 全胸腔镜手术, 临床分析

Abstract: 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.

Key words: Mediastinal cyst, Diagnosis, Totally thoracoscopic surgery, Clinical analysis

中图分类号:

R655.5

朱勇, 施舜缤, 张林, 王海龙, 钱涛涛. 纵隔囊肿诊断及全胸腔镜手术治疗32例临床分析[J]. 承德医学院学报, 2019, 36(4): 288-290.

ZHU Yong, SHI Shun-bin, ZHANG Lin, et al. CLINICAL ANALYSIS OF DIAGNOSING AND TOTAL THORACOSCOPIC SURGERY FOR MEDIASTINAL CYSTS OF 32 CASES[J]. Journal of Chengde Medical University, 2019, 36(4): 288-290.

参考文献

[1] DIENEMANN H C, HOFFMANN H, DETTERBECK F C.Chest Surgery[M]. Springer: Berlin Heidelberg, Germany, 2015: 335.
[2] PONN R B.Simple mediastinal cysts: resect them all?[J]. Chest, 2003, 124(1): 4-6.
[3] ESME H, EREN S, SEZER M, et al.Primary mediastinal cysts: clinical evaluation and surgical results of 32 cases[J]. Tex Heart Inst J, 2011, 38(4):371-374.
[4] MATURU V N, DHOORIA S, AGARWAL R.Efficacy and Safety of Transbronchial Needle Aspiration in Diagnosis and Treatment of Mediastinal Bronchogenic Cysts: Systematic Review of Case Reports[J]. J Bronchology Interv Pulmonol, 2015, 22(3):195-203.
[5] KOZU Y, SUZUKI K, OH S, et al.Single institutional experience with primary mediastinal cysts: clinicopathological study of 108 resected cases[J]. Ann Thorac Cardiovasc Surg, 2014, 20(5): 365-369.
[6] CHAUDHARI J, FERNANDEZ G, NAIK L, et al.Intrathyroidal multiloculated proliferating thymic cyst[J]. Endocr Pathol, 2015, 26(1): 45-47.
[7] MIZUTANI E, NAKAHARA K, MIYANAGA S, et al.A thymic cyst in the middle mediastinum: report of a case[J]. Ann Thorac Cardiovasc Surg, 2013, 19(1): 43-45.
[8] 余洪,刘衡,罗显丽,等.纵隔支气管囊肿CT表现及其病理基础[J].中国CT和MRI杂志,2016,14(9):56-58.
[9] 张蕴,杜红文,付和睦,等.原发纵隔囊肿影像学表现[J].实用放射学杂志,2007,23(12):1615-1618.
[10] ARAKI T, SHOLL L M, GERBAUDO V H, et al.Intrathymic cyst: clinical and radiological features in surgically resected cases[J]. Clin Radiol, 2014, 69(7): 732-738.
[11] ELDIB O S, SALEM A.Surgical management of mediastinal cysts[J]. Journal of the Egyptian Society of Cardio-Thoracic Surgery, 2016, 24(1):58-64.
[12] 周勇,王文公,张青海,等.电视胸腔镜下纵隔囊肿切除术12例报告[J].中国微创外科杂志,2013,13(2):189-190.
[13] BRZEZIŃSKI D, LOCHOWSKI M P, KOZAK J. Videothoracoscopy in the treatment of mediastinal cysts[J]. Wideochir Inne Tech Maloinwazyjne, 2014, 9(3): 393-397.
[14] 王希龙,许世广,童向东,等.纵隔囊肿的外科治疗:达芬奇机器人与电视胸腔镜手术比较[J].临床军医杂志,2015,43(7):669-673.

[1]	宋明泽, 曹海营, 张亚芳, 金宇. 左股骨巨大尤因肉瘤1例[J]. 承德医学院学报, 2021, 38(4): 343-343.
[2]	张天资, 孙婕, 田江灵, 冯平勇. 儿童硬脑膜动静脉瘘1例[J]. 承德医学院学报, 2021, 38(3): 253-253.
[3]	陈珂. WB-DWI对肺癌及其转移灶和淋巴结受累的诊断分析[J]. 承德医学院学报, 2021, 38(2): 116-118.
[4]	邓雁秀, 黎冠东, 李伟, 刘壮盛. 探讨双源高分辨螺旋CT颈部血管造影对脑梗死的诊断价值[J]. 承德医学院学报, 2021, 38(2): 119-121.
[5]	陈靖予, 韩若凌. 超声弹性成像技术在前列腺癌筛查和诊断中的应用进展[J]. 承德医学院学报, 2021, 38(2): 142-144.
[6]	段延龙, 田强, 石秋艳, 李弘, 张梦柯, 张春阳. 桥本脑病1例[J]. 承德医学院学报, 2021, 38(2): 163-164.
[7]	王丽娟, 刘燕. miR-708在儿童急性淋巴细胞白血病中的诊断及预后[J]. 承德医学院学报, 2021, 38(1): 1-5.
[8]	卓艳霞, 孙明昌, 张永卓. 儿童急性淋巴细胞白血病中miR-326的表达及临床意义[J]. 承德医学院学报, 2021, 38(1): 9-12.
[9]	王晓辉, 龚明玉. ARID家族在肝癌中的研究进展[J]. 承德医学院学报, 2021, 38(1): 56-59.
[10]	谢冬雪, 张淑君. 咽喉反流与阻塞性睡眠呼吸暂停低通气综合征相关研究进展[J]. 承德医学院学报, 2021, 38(1): 63-66.
[11]	宋天娇, 王佩. 脑淀粉样血管病1例[J]. 承德医学院学报, 2019, 36(6): 523-524.
[12]	李莉, 郑跃杰, 李晶, 王文建. 儿童弓形虫病3例临床分析[J]. 承德医学院学报, 2019, 36(5): 390-392.
[13]	赖小惠, 郑秀丽, 梁月贞, 梁汉成. 肺结核患者实施个体化营养支持40例临床分析^*[J]. 承德医学院学报, 2019, 36(5): 436-437.
[14]	周亚男, 宋金起, 许长理, 徐辉. 原发巨大输尿管息肉1例[J]. 承德医学院学报, 2019, 36(4): 343-345.
[15]	程浪, 李亚伟, 李生辉, 程庆水, 黄后宝. 膀胱原位癌的最新诊治研究进展^*[J]. 承德医学院学报, 2019, 36(3): 251-254.