縦隔神経原性腫瘍切除例の検討

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  • CLINICOPATHOLOGICAL STUDY ON SURGICALLY TREATED CASES OF NEUROGENIC MEDIASTINAL TUMORS

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Sixty-two patients with neurogenic mediastinal tumor surgically treated in our department from 1969 to 1997 except for neuroblastoma were clinicopathylogically reviewed. Tumors existed on the right side of the mediastinum in 37 patients, on the left in 25 patients, and were located above the Th 4 frequently. Chest roentgenograms showed development of tumors in 36.8% of cases who had observation periods before surgery. There were no malignant tumors and tumors grew from sympathetic nerves in 32 patients, intercostal nerves in 21, vagus nerves in five, and phrenic nerve in one. An operation was carried out to resect tumors completely for every patient, in five patients, however, complete resection was not possible because tumors extended into cervical motor nerves. As a result of surgery, 23 patients suffered from postoperative complication (Horner syndrome in 15 patients, bleeding in 3. hoarseness in 2, and pain in 2), and there were no recurrence even in the five patients for whom complete resection was impossible.<br> Therefore, we would conclude that neurogenic mediastinal tumors should be resected surgically with keeping up nervous function. Taking its less stress into consideration, thoracoscopic resection must be the management of first choice.

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