用于小儿肿瘤切除术的瓣膜胸廓切开术:病例系列

Janet R. Julson , Rene P. Myers , William H. Gray , Jamie M. Aye , Elizabeth D. Alva , Elizabeth A. Beierle
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引用次数: 0

摘要

导言小儿患者胸膜腔或纵隔内的巨大肿块可能会给手术带来挑战,不仅要在小胸腔内获得足够的空间以进行安全的解剖,还要实现充分的胸腔闭合。他们的主要症状是慢性咳嗽和胸痛。患者 1 是一名 13 岁的男性,有脊柱裂病史,纵隔/右胸腔内有一个 12 × 10 × 9 厘米的恶性生殖细胞瘤。患者 2 是一名 18 岁的男性,后纵隔/右半胸有一个 24 × 15 × 11 厘米的右胸滑膜肉瘤。患者 3 是一名 14 岁男性,后纵隔/右半胸有一个 19 × 14 × 10 厘米的淋巴管畸形。这三位患者都是通过蛤壳式喉咙切开术切除肿瘤后,采用胸骨钢板进行胸骨伤口闭合。术后并发症包括浅表手术部位感染和糜烂渗漏,但没有伤口裂开或破裂。使用胸骨钢板可使胸骨充分愈合。
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Clamshell thoracotomy for pediatric tumor resection: A case series

Introduction

Large masses in the pleural cavity or mediastinum in pediatric patients may present an operative challenge, not only in terms of obtaining adequate space in the small chest for safe dissection, but in attaining adequate chest closure.

Case series

Three adolescent males presented with large masses in the mediastinum or thoracic cavity. Their presenting signs were primarily chronic cough and chest pain. Patient 1 was a 13-year-old male with a history of spina bifida and a 12 × 10 × 9 cm malignant germ cell tumor in the mediastinum/right chest. Patient 2 was an 18-year-old male with a 24 × 15 × 11 cm right thoracic synovial sarcoma in the posterior mediastinum/right hemithorax. Patient 3 was a 14-year-old male with a 19 × 14 × 10 cm lymphovascular malformation in the posterior mediastinum/right hemithorax. In all three patients, after the resection of the tumor via a clamshell throacotomy, sternal plating was employed for sternal wound closure. Post operative complications included a superficial surgical site infection and a chyle leak, but no wound dehiscence or breakdown.

Conclusion

The bilateral clamshell thoracotomy is a suitable approach for the resection of extensive mediastinal and thoracic masses in adolescents. The use of a sternal plate leads to adequate sternal healing.

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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
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