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目的 探讨胸椎哑铃型神经源性肿瘤的手术方法。方法 1991年3月至1999年3月经胸联合后正中入路一期切除胸椎哑铃型神经源性肿瘤7例,其中神经纤维瘤4例,神经鞘瘤2例,恶性神经鞘瘤1例。结果 6例获肉眼下全切除,1例次全切除,所有患者症状均不同程度改善。随访6例,平均3.5年,5例正常生活、工作,1例恶性神经鞘瘤3月前次全切除刚结束放射治疗,未见复发。结论 经胸联合后正中入路能满意暴露肿瘤,安全切除复杂的胸椎哑铃型神经源性肿瘤。
Objective To explore the surgical method of thoracic dumbbell-type neurogenic tumors. METHODS: From March 1991 to March 1999, 7 cases of dumbbell-shaped neurogenic tumors of the thoracic vertebrae were removed at the midline of the transthoracic approach. There were 4 cases of neurofibromatosis, 2 cases of schwannomas, and 1 case of malignant schwannoma. Results Six cases were totally removed under the naked eye and one case was subtotally removed. The symptoms of all patients were improved to different degrees. Six patients were followed up for an average of 3.5 years. Five patients had normal living and work. One case of malignant schwannoma had just completed radiation therapy 3 months before the total resection. No recurrence was found. Conclusions Transthoracic combined posterior median approach can satisfactorily expose tumors and safely remove complex thoracic dumbbell-type neurogenic tumors.