目的:探讨颈胸联合部肿瘤手术治疗的有关技术问题。方法:16例颈胸联合部肿瘤施行手术。颈正中加胸骨正中切口4例,颈正中、胸骨次全劈开(第3前肋间平面以上)和胸部前外侧联合切口(hemi-shellincision,半蛤壳状切口)12例。结果:全组无手术死亡,声音嘶哑3例,术后3～6个月恢复,无永久性声带麻痹。1例原始神经外胚层瘤术后18个月发生右肺尖转移,行右上肺楔形切除,术后26个月再发心包转移,行心包及局部壁层胸膜切除。随访4～72个月,晚期死亡3例,均属恶性肿瘤。出血、喉返神经损伤及呼吸道受阻为术后主要并发症。结论:颈胸联合部肿瘤组织来源呈多样化,以神经源性肿瘤多见;一经确诊应争取手术治疗;半蛤壳切口创伤稍大,但术野清晰,利于防止副损伤;肿瘤切除时要防止大血管的损伤。术中注意气管的悬吊复位,利于保持气管通畅。 Objective: To explore the related technical problems of surgical treatment of tumor in the neck and thoracic area. Methods: Twenty - six patients with neck and thoracic tumor underwent surgery. In the middle of the neck, there were 4 cases of median incision of the sternum, middle of the neck, subtotal sternotomy (above the third anterior intercostal plane) and hemi-shell incision (hemiseptal incision). Results: There were 3 cases of no operative death and hoarseness in the whole group, 3 to 6 months after operation, and no permanent vocal cord paralysis. One case of primary neuroectodermal tumor developed right apex at 18 months postoperatively. The right upper quadrant wedge resection was performed. Pericardial metastasis was performed at 26 months after operation. Pericardium and partial parietal pleural resection were performed. Follow-up 4 to 72 months, 3 patients died of advanced stage, are malignant tumors. Bleeding, recurrent laryngeal nerve injury and airway obstruction were major complications after operation. Conclusion: The sources of tumor tissue in the cervical-thoracic and thoracic joint are diversified, with neurogenic tumors more common. Surgical treatment should be given after diagnosis. The wounds of the clam shell incision are slightly larger, but the surgical field is clear, which will help to prevent the secondary injury. Prevent damage to large blood vessels. Tracheal attention to the suspension during surgery, which will help maintain tracheal patency.