Video-assisted thoracic surgery resection for pediatric mediastinal neurogenic tumors
Video-assisted thoracic surgery resection for pediatric mediastinal neurogenic tumors
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DOI：
10.1016/j.jpedsurg.2012.01.067
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发表时间：
2012-07-01
影响因子：
2.4
通讯作者：
Pierro, Agostino
中科院分区：
文献类型：
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作者：
Fraga, Jose Carlos;Rothenberg, Steven;Pierro, Agostino
背景/目的：电视辅助胸腔镜手术（VATS）切除纵隔神经源性肿瘤在儿童中仍存在争议。本研究的目的是回顾来自不同国家3家机构的儿童此类肿瘤的VATS切除病例。方法：这项回顾性研究包括1995年7月至2011年2月期间治疗的17名儿童。回顾病历，收集年龄、性别、肿瘤组织学类型、临床表现、手术时年龄和体重、肿瘤大小、胸腔引流时间、手术并发症、肿瘤复发和死亡率等数据。结果：13研究对象为男性 (76.5%) 和女性 4 名 (23.5%)。中位年龄为 16 个月（范围为 10.6-60 个月），中位体重为 11.9 公斤（范围为 9.3-27.4 公斤）。 10 名儿童患有神经母细胞瘤（58.8%），4 名患有神经节神经瘤（23.5%），3 名患有神经节神经母细胞瘤（17.7%）。手术中位持续时间为 90 分钟（范围为 45-180 分钟），所有病例均完成胸腔镜切除。两名儿童（11.8%）术后出现霍纳综合征。中位随访时间为 16 个月（8.9-28.6 个月），无死亡病例，无复发情况。结论：电视胸腔镜手术切除儿童纵隔神经源性肿瘤效果良好，无复发，术后并发症极少。这种方法的主要优点是避免开胸手术并发症，并通过改善可视化来提高手术准确性。 (C) 2012 Elsevier Inc. 保留所有权利。
Background/Purpose: Video-assisted thoracoscopic surgery (VATS) resection of mediastinal neurogenic tumors is still controversial in children. The aim of this study was to review the cases of VATS resection of such tumors in children from 3 institutions located in different countries.Methods: This retrospective study included 17 children treated between July 1995 and February 2011. Medical charts were reviewed for collection of data on age, sex, histologic type of tumor, clinical manifestations, age and weight at surgery, tumor size, duration of thoracic drainage, surgical complications, tumor recurrence, and mortality.Results: Thirteen (76.5%) males and 4 (23.5%) females were studied. Median age was 16 months (range, 10.6-60 months), and median weight was 11.9 kg (range, 9.3-27.4 kg). Ten children had neuroblastoma (58.8%), 4 had ganglioneuroma (23.5%), and 3 had ganglioneuroblastoma (17.7%). The median duration of the operation was 90 minutes (range, 45-180 minutes), with complete thoracoscopic resection in all cases. Two children (11.8%) developed Horner syndrome postoperatively. No deaths were reported, and no recurrence was noted during a median follow-up period of 16 months (range, 8.9-28.6 months).Conclusions: Video-assisted thoracoscopic surgery resection of mediastinal neurogenic tumors in children produced good results, with no recurrence and minimal postoperative complications. The major advantages of this approach are the avoidance of thoracotomy complications and the enhanced surgical accuracy provided by improved visualization. (C) 2012 Elsevier Inc. All rights reserved.