"Dumbbell" tumors in posterior mediastinum and intravertebral area; a report of 5 cases with special reference to the surgical approach.

概要

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The surgical tactics for the removal of Dumbbell mediastinal tumors are still controversial. Five patients with Dumbbell tumors have been operated on in the Center for Adult Disease, Osaka. A thoracic approach was chosen in two patients, a laminectomy and standard thoracotomy in two and Grillo's approach in one. Postoperative leakage of cerebro-spinal fluid occurred in two treated with a thoracic approach. Therefore, a neurological operation is essential to remove the intraspinal tumor safely and to prevent neurologial complications. Grillo's approach has the advantage of providing a wide view from a single position, but it has the disadvantage of cutting muscles and ribs. In case 4, a laminectomy was performed in the prone position. After the intraspinal component of the dumbbell tumor was separated from the spinal cord, the patient was moved a lateral position. Then a thoracotomy was done using a lateral skin incision without dividing the latissimus dorsi or the serratus anterior muscle to preserve upper limb function. We believe that this combined approach is more conservative than Grillo's method for the resection of benign dumbbell tumors.
特定非営利活動法人日本呼吸器外科学会の論文