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目的总结胸腺瘤的临床病理特点、手术方法及预后因素。方法 66例胸腺瘤患者按Masaoka 临床分期,根据肿瘤的生长情况确定术式,包括采用胸部正中切口或胸前外侧切口,完整或姑息切除胸腺瘤。结果在66例胸腺瘤中伴重症肌无力者14例(21.2%),Masaoka Ⅰ期29例(43.9%),Ⅱ期16例(24.2%),Ⅲ期19例(28.8%),Ⅳ期2例(3.0%)。全胸腺及胸腺瘤切除14例,单纯胸腺瘤切除40例,肿瘤部分切除5例,开胸探查肿瘤活检6例,颈部淋巴结活检1例。合并心包切除7例,上腔静脉部分切除2例,肺部分切除1例。术后30 d 内死亡1例,术后24例辅助放疗,2例辅助化疗,4例复发。结论胸腺瘤应尽量手术切除,即使不能完整切除,也应部分切除肿瘤,术后辅助放化疗。
Objective To summarize the clinicopathological features, surgical methods and prognostic factors of thymoma. Methods 66 cases of thymoma patients according to Masaoka clinical stage, according to the growth of the tumor to determine the surgical procedures, including the use of the median incision or chest thoracic lateral incision, complete or palliative resection of thymoma. Results Sixty-four patients (21.2%) had mastectomy myasthenia gravis, 29 (43.9%) had Masaoka I, 16 (24.2%) had stage II, 19 (28.8%) had stage III, Example (3.0%). Thoracic and thymoma resection in 14 cases, simple thymoma resection in 40 cases, partial resection of the tumor in 5 cases, thoracotomy detection of tumor biopsy in 6 cases, 1 case of cervical lymph node biopsy. 7 cases were complicated with pericardiocervical resection, 2 cases were partially resected in the superior vena cava, and 1 case was partially resected in the lung. One patient died within 30 days after operation, 24 patients received adjuvant radiotherapy, 2 patients received adjuvant chemotherapy and 4 patients relapsed. Conclusion Thymoma should be resected as much as possible, even if it can not be completely resected, it should be partial removal of the tumor, adjuvant radiotherapy and chemotherapy.