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目的:探讨在胸腔镜辅助下行胸椎转移性肿瘤前路手术切除的方法及效果。方法:在胸腔镜辅助下对11例胸椎转移瘤患者行病椎切除及椎体重建术,术前神经功能ASIA分级A级1例,C级6例,D级4例。7例行病椎切除及钢板骨水泥椎体重建术;4例行病椎切除、钢板骨水泥椎体重建及内固定术。结果:手术均获成功,术中肿瘤切除满意,术后影像学显示内固定固定确切。随访4～14个月,平均8个月,胸背痛均完全消失,术后神经功能除1例A级无恢复外,其余均明显恢复;1例因肿瘤脑转移4个月死亡,其余患者存活8个月以上,其中1例乳腺癌术后多椎体转移患者手术后14个月随访时仍存活。结论:在胸腔镜辅助下行胸椎转移肿瘤切除椎体重建术安全、有效,可提高患者的生活质量。
Objective: To explore the method and effect of anterior thoracoscopic surgery for thoracic metastatic tumors. METHODS: Thirteen thoracic metastatic tumor patients underwent thoracoscopic assisted vertebral resection and reconstruction of the vertebral body. Preoperative neurological function ASIA grade A in 1 case, C in 6 cases, D in 4 cases. Seven patients underwent spinal excision and bone plate cement reconstruction. Four patients underwent spinal excision, bone plate cement reconstruction and internal fixation. Results: All the operations were successful. The resection of the tumor was satisfactory. Postoperative imaging showed that the internal fixation was fixed. After 4 to 14 months of follow-up, an average of 8 months, all the chest and back pain disappeared completely. The postoperative neurological function was significantly restored except for one case of grade A without recovery. One patient died due to tumor brain metastasis for 4 months. Over 8 months of survival, one patient with multiple vertebral metastases after breast cancer surgery survived after 14 months of follow-up. Conclusion: Thoracoscopic assisted thoracic vertebral metastases resection of vertebral reconstruction is safe and effective, and can improve the quality of life of patients.