PDF(Pubmed)
Abstract：
Solid tumors of the cervicothoracic junction, the posterior mediastinum, or bilateral dorsal thoracic tumors represent a challenge in pediatric surgical oncology. The aim of this study was to evaluate trap-door thoracotomy and clamshell thoracotomy as surgical approaches. A single-center retrospective study of children with solid tumors in these specific localizations was performed. From 2015 to 2023, 26 children (17 girls; 9 boys) were treated at a median age of 54 months (range 8-229). Tumor resection was performed for neuroblastoma (n = 11); metastatic disease (n = 7); malignant rhabdoid tumor (n = 4); Ewing sarcoma (n = 1); inflammatory myofibroblastic tumor (n = 1); rhabdomyosarcoma (n = 1); and neurofibroma (n = 1). The surgical goal of macroscopic complete excision was achieved in all of the 14 children who underwent trap-door thoracotomy and in 11 of the 12 children who underwent clamshell thoracotomy. There were no major complications. At a median follow-up of 8 months (range 0-60), the disease was under local control or in complete remission in 66.7% of the children. In conclusion, surgical resection of solid tumors of the cervicothoracic junction in children can be performed safely and successfully with trap-door thoracotomy and with clamshell thoracotomy for posterior mediastinal or bilateral dorsal thoracic tumors.
摘要：
颈胸交界处实体瘤，后纵隔,或双侧胸部背侧肿瘤是儿科外科肿瘤学的挑战。这项研究的目的是评估活门开胸手术和蛤壳式开胸手术作为手术方法。对这些特定部位的实体瘤儿童进行了单中心回顾性研究。从2015年到2023年，26名儿童（17名女孩；9名男孩）接受了治疗，中位年龄为54个月（范围为8-229）。神经母细胞瘤（n=11）；转移性疾病（n=7）；恶性横纹肌样瘤（n=4）；尤因肉瘤（n=1）；炎性肌纤维母细胞瘤（n=1）；横纹肌肉瘤（n=1）；和神经纤维瘤（n=1）。在所有14例接受活门开胸手术的儿童中，以及在12例接受蛤壳式开胸手术的儿童中，有11例实现了宏观完全切除的手术目标。无重大并发症。在中位随访8个月（范围0-60），66.7%的儿童疾病在当地得到控制或完全缓解。总之,儿童颈胸交界处实体瘤的手术切除可以安全，成功地进行陷门开胸手术和蛤壳式开胸手术治疗后纵隔或双侧背侧胸部肿瘤。
