Combined hemilaminectomy and thoracolaparoscopic surgery for removal of dumbbell tumors of thoracolumber spine

目的 探讨后正中椎板切除联合胸(腹)腔镜手术切除胸腰椎管哑铃形肿瘤的方法与可行性.方法 应用半椎板切除联合胸(腹)腔镜技术一期对4例胸腰椎管哑铃形肿瘤施行了手术.先通过神经外科显微手术切除椎管内肿瘤.再经胸(腹)腔镜切除胸腹腔椎旁肿瘤.结果 肿瘤全切3例,次全切1例.手术耗时4-6h,出血量100-200ml.术后临床症状明显改善,无手术并发症.术后随访6个月-3年未见肿瘤生长或复发.结论 后正中入路联合胸(腹)腔镜手术一期切除胸腰椎管哑铃形肿瘤创伤小,术后疼痛轻,并发症少,是一种较为理想的手术方法.Objective To describe combined hernilaminectomy and thoracolaparoscopic surgery for removal of dumbbell tumors of the thoracolumber spine and demonstrate the feasibility of this approach.Methods Four cases of dumbbell tumors of the thoracohmber spine were resected using a combined hemilaminectomy and thoracolaparoscopic procedure in a single stage.The part of the tumor in spinal caual and intervertebral foramen Was first removed by micmneurosurgery.The part of the tumor in thoracic and lumber cavities was then removed by thoracoLaparescopic techniques.Results A gross total tumor resection Was achieved in three patients.and subtotal resection in one patienL The entire operative time was 4-6hours.The estimated blood loss Was 100～200 ml.The clinical symptoms were obviously impmved in all patients postoperatively.There Wag no operative complication.The follow-up was carried from 6 months to 3 years after operation and there wes 110 evidence of recurrent tumor.Conclusion This minimally invasive technique has the advantages of less smocal stress,avoiding the potential morbidity of a thoracotomy,avoiding the extensive muscle dissection and pain associated with the lateral extracavity approach.It may be a good alternative for the resection of thomcolumber dumbbell tumors.中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)04333-3352