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目的 总结6年间手术治疗的108例恶性胸腺肿瘤的经验。方法 按肿瘤大小及位置分别采用胸骨正中切口和/或前外侧切口、后外侧切口施术。结果 恶性胸腺肿瘤极易发生心包及前纵膈大血管浸润,术中难以将肿瘤完整切除,能够完整切除者常需合并大血管切除或置换术。肿瘤有残留组术后剖面追加放射治疗,其1年、3年生存率仅略低于完整切除组而明显高于单纯探查组(P<0.01)。结论 恶性胸腺肿瘤手术的原则是即使不能完整切除肿瘤也应尽量将可切除部分切除。
Objective To summarize the experience of 108 cases of malignant thymoma treated by surgery during 6 years. Methods The sternal median incision and/or anterolateral incision and posterolateral incision were performed according to the size and location of the tumor. RESULTS: Malignant thymic neoplasms were prone to pericardial and anterior mediastinal infiltrates, and it was difficult to completely resect the tumors during surgery. Complete resections often required the removal of large vessels or replacement. There was a residual radiotherapy in the residual group of tumors. The one-year and three-year survival rates were slightly lower than those in the complete resection group and significantly higher than those in the simple exploration group (P<0.01). Conclusion The principle of surgery for malignant thymic tumors is that even if the tumor cannot be completely removed, the resectable part should be removed as much as possible.