【作者】 张波；

【导师】 晏怡；

【作者基本信息】 重庆医科大学 ， 外科学， 2015， 硕士

【摘要】 [目的]探讨经单后路切除突入胸腔内的巨大椎管哑铃状肿瘤的手术方法及效果。[方法]回顾性分析我院神经外科2012年2月至2014年2月间采用单一后正中直切口入路行手术切除的12例突入胸腔内的巨大椎管哑铃状肿瘤病例,与文献中采用胸腔镜联合后正中入路以及后正中联合椎旁入路行手术切除的类似病例的手术情况进行对比。[结果]3组全部病例均完成了肿瘤全切除。本组1例同时行脊柱内固定术,手术时间120-315min,平均195min,术中出血量50-300ml,平均205ml；经胸腔镜联合后正中入路组手术时间320-340分钟,平均328分钟,出血量450-500ml,平均483ml；经后正中联合椎旁切口入路组全部患者同时行脊柱内固定术,手术时间185-420分钟,平均313分钟,术中出血量71-1830ml,平均657ml。[结论]突入胸腔内的巨大椎管哑铃状肿瘤多数可经单后路正中直切口进入而无需开胸,亦无需辅助入路及肋骨切除,即可达到肿瘤全切除,该手术方式创伤小、手术时间短、出血量少。更多还原

【Abstract】 ObjectiveTo study the surgical technique and to evaluate the outcome of purely posterior resection for large spinal dumbbell-shaped tumors that extend into the thoracic cavity.Methods:We retrospectively analyzed 12 cases of large dumbbell-shaped tumors that extend into the thoracic cavity our department admitted between February 2012 and February 2014,all cases were operated through a purely posterior approach, operation data were compared with similar cases that through thoracoscopic combined with posterior approach and posterior combined with paravertebral approach in literaturesResultsAll patients in 3 groups were achieved total resection, one patient in our group required spinal internal fixation, operation time was 120-315minutes,mean 195 minutes, blood loss was 50-300ml, mean 205ml; in the thoracoscopic combined with posterior approach group, operation time was 320-340minutes,mean 328 minutes, with 450-500ml blood loss, mean 483ml; all patients in the posterior combined with paravertebral approach group required spinal internal fixation, operation time was 185-420minutes,mean 313 minutes, with 71-1830ml blood loss, mean 657ml.ConclusionsMost cases of large spinal dumbbell-shaped tumors that extend into the thoracic cavity can be totally resected by purely posterior approach without thoracotomy,or assisted approach and rib resection, this surgical approach is minimally invasive with shorter operation time and less blood loss.更多还原