目的 研究胸部血管瘤的臨床與病理學(xué)特點(diǎn),提高臨床診斷的準(zhǔn)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(xué)華西醫(yī)院接受手術(shù)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(shù)6例,全胸腔鏡手術(shù)1例,胸腔鏡輔助小切口手術(shù)1例,由神經(jīng)外科和胸外科分期完成手術(shù)1例。分析其影像學(xué)特點(diǎn)、術(shù)中腫瘤的大體特點(diǎn)和手術(shù)標(biāo)本的病理學(xué)特點(diǎn),比較不同手術(shù)方式治療血管瘤的效果。 結(jié)果 本組手術(shù)治療血管瘤患者9例,影像學(xué)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(duì)術(shù)前診斷血管瘤具有一定的價(jià)值,特點(diǎn)是T2加權(quán)像瘤體增強(qiáng)。胸外科手術(shù)時(shí)間106.3±60.1 (60~192) min,術(shù)中出血量91.1±43.7 (30 ~150) ml。除1例患者隨訪1個(gè)月外,其余均隨訪3~6年,所有患者均無(wú)與本病相關(guān)的死亡發(fā)生,無(wú)復(fù)發(fā)和轉(zhuǎn)移。 結(jié)論 胸部血管瘤大多為良性腫瘤,主要位于縱隔;結(jié)合血管瘤的大小、部位和醫(yī)生的技術(shù)水平?jīng)Q定手術(shù)方式,胸腔鏡手術(shù)對(duì)于血管瘤具有創(chuàng)傷小、出血少和住院時(shí)間短的優(yōu)點(diǎn);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(diǎn)與外科治療. 中國(guó)胸心血管外科臨床雜志, 2013, 20(1): 67-69. doi: 復(fù)制
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. |
- 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.