CAJ | 학술논문

目的探讨经胸骨L形切口切除前纵隔肿瘤的可行性.方法 18例前纵隔肿瘤患者,采用全麻单腔气管插管,胸部正中8～10 cm切口,根据肿瘤的大小及部位,选取第3或第4肋间横断胸骨(向左或向右),直视下切除肿瘤.结果 17例患者经此切口完整切除肿瘤或囊肿,其中3例侵犯邻近肺组织,予以肺部分切除,2例侵犯心包,予以心包部分切除.1例侵犯重要血管,姑息性切除.平均手术时间120 min(80～140min),术后均恢复顺利,术后平均住院时间10 d,2例肺部感染.术后平均随访时间为24个月(8～36个月).结论经胸骨L形切口手术创伤较小,术后恢复较快,能在直视下完整切除前纵隔肿瘤或囊肿,是一种可供选择的手术方法.
목적 탐토경흉골L형절구절제전종격종류적가행성.방법 18례전종격종류환자,채용전마단강기관삽관,흉부정중8～10 cm절구,근거종류적대소급부위,선취제3혹제4륵간횡단흉골(향좌혹향우),직시하절제종류.결과 17례환자경차절구완정절제종류혹낭종,기중3례침범린근폐조직,여이폐부분절제,2례침범심포,여이심포부분절제.1례침범중요혈관,고식성절제.평균수술시간120 min(80～140min),술후균회복순리,술후평균주원시간10 d,2례폐부감염.술후평균수방시간위24개월(8～36개월).결론 경흉골L형절구수술창상교소,술후회복교쾌,능재직시하완정절제전종격종류혹낭종,시일충가공선택적수술방법.
Objective To explore the feasibility of the small figure-L unilateral transternal incision for the treatment of anterior mediastinal tumor and cyst. Methods Eighteen patients with anterior mediastinal tumor or cyst were enrolled in the study. Under general anesthesia, after a 8 to 10 cm middle skin incision was made, a unilateral figure-L partial sternotomy on the side occupied by the tumors was made in the third or forth intercestals space,taking into account the tumors size and location. Tumors were resected with excellent exposure. Results All but one tumors were completely resected during the operation. In 3 cases,tumors encroached on the adjacent lung tissue,and lung tissue was partially resected. In 2 cases, tumors invaded the pericardium, and the pericardium was partially removed.Mean operating time was 120 minutes( 80～140 minutes). The mean time of hospital stay was 10 days after the operation, and there was no complications. All patients were alive with a mean follow-up period of 24 months ( 8～36 months). Conclusion The figure-L unilateral sternotomy is an effective and useful minimally invasive approach for anterior mediastinal tumors.