目的 研究胸部血管瘤的臨床與病理學特點,提高臨床診斷的準確性,減少并發(fā)癥。 方法 回顧性分析2006年1月至2012年8月在四川大學華西醫(yī)院接受手術治療的胸部血管瘤患者9例,男 2例,女 7例;年齡47.9±19.3 (18 ~71)歲 。開胸手術6例,全胸腔鏡手術1例,胸腔鏡輔助小切口手術1例,由神經(jīng)外科和胸外科分期完成手術1例。分析其影像學特點、術中腫瘤的大體特點和手術標本的病理學特點,比較不同手術方式治療血管瘤的效果。 結果 本組手術治療血管瘤患者9例,影像學上表現(xiàn)為類圓形占位占66.7% (6/9),分葉狀占位占33.3% (3/9);磁共振成像(MRI) 檢查對術前診斷血管瘤具有一定的價值,特點是T2加權像瘤體增強。胸外科手術時間106.3±60.1 (60~192) min,術中出血量91.1±43.7 (30 ~150) ml。除1例患者隨訪1個月外,其余均隨訪3~6年,所有患者均無與本病相關的死亡發(fā)生,無復發(fā)和轉移。 結論 胸部血管瘤大多為良性腫瘤,主要位于縱隔;結合血管瘤的大小、部位和醫(yī)生的技術水平?jīng)Q定手術方式,胸腔鏡手術對于血管瘤具有創(chuàng)傷小、出血少和住院時間短的優(yōu)點;啞鈴型血管瘤需要與神經(jīng)外科醫(yī)生協(xié)同完成。
引用本文: 林一丹,蔣光亮. 胸部血管瘤的臨床特點與外科治療. 中國胸心血管外科臨床雜志, 2013, 20(1): 67-69. doi: 復制
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- 1. Yoshino N, Okada D, Ujiie H, et al. Venous hemangioma of the posterior mediastinum. Ann Thorac Cardiovasc Surg, 2012, 18 (3):247-250.
- 2. Bubnjar J, Pape? D. Rib hemangioma presenting as an asymptomatic mass. Am Surg, 2012, 78 (4):E238-E239.
- 3. Odaka M, Nakada T, Asano H, et al. Thoracoscopic resection of a mediastinal venous hemangioma:Report of a case. Surg Today, 2011, 41 (10):1455-1457.
- 4. Lovrenski A, Panjkovi? M, Eri Z, et al. Cavernous hemangioma of the lung. Med Pregl, 2011, 64 (5-6):327-330.
- 5. Mizutani E, Morita R, Kitamura S. Arteriovenous hemangioma in the middle mediastinum:report of a case. Surg Today, 2011, 41 (6):846-848.
- 6. Hashimoto N, Takenaka S, Akimoto Y, et al. Capillary hemangioma in a rib presenting as large pleural effusion. Ann Thorac Surg, 2011, 91 (4):e59-e61.
- 7. Sakurai K, Hara M, Ozawa Y, et al. Thoracic hemangiomas:imaging via CT, Mr, and PET along with pathologic correlation. J Thorac Imaging, 2008, 23 (2):114-120.
- 8. Cohen AJ, Sbaschnig RJ, Hochholzer L, et al. Mediastinal hemangiomas. Ann Thorac Surg, 1987, 43 (6):656-659.
- 9. Kanaya H, Saito Y, Gama N, et al. Intramuscular hemangioma of masseter muscle with prominent formation of phleboliths:a case report. Auris Nasus Larynx, 2008, 35 (4):587-591.
- 10. Hirai K, Takeuchi S, Bessho R, et al. Venous hemangioma of the anterior mediastinum. J Nippon Med Sch, 2010, 77 (2):115-118.
- 11. Liu LX, Che GW, Pu Q, et al. A new concept of endoscopic lung cancer resection:Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19 (2):e71-e77.
- 12. Flores RM, Alam N. Video-assisted thoracic surgery lobectomy (VATS), open thoracotomy, and the robot for lung cancer. Ann Thorac Surg, 2008, 85 (2):S710-S715.
- 13. Cano I, Antón-Pacheco JL, García A, et al. Video-assisted thoracoscopic lobectomy in infants. Eur J Cardiothorac Surg, 2006, 29 (6):997-1000.
- 14. Yan TD, Black D, Bannon PG, et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol, 2009, 27 (15):2553-2562.