胸部・縦隔神経芽腫に対する胸腔鏡下手術

Video-assisted Thoracic Surgery for Mediastinal Nueroblastoma

　病期Ⅰ，Ⅱ期の胸部縦隔神経芽腫7例に対してミニ開胸を伴う胸腔鏡下手術を行った．6例が6か月，14か月マススクリーニング発見例である．それらのなかで1例は術中に肋間筋浸潤と判断し，開胸に変更した．胸腔鏡下手術の平均手術時間は118±26分であった．すべての症例は1〜52か月の経過観察期間で無再発生存中である．病期I,II期の胸部縦隔神経芽腫は生物学的性状が良性で，術後の再発がきわめて稀であるので，胸腔鏡下手術はよい適応である．

Video-assisted thoracic surgery (VATS) with mini-thoracotomy was performed on seven patients with stage I and II mediastinal neuroblastomas. Six patients were identified by mass screening of infants at the age of 6 or 14 months. In one case, infiltration of the intercostal muscles was found and resection was performed by conversion to open thoracotomy. The mean duration of the procedures of VATS was 118 ±26 minutes. All patients have survived, with no evidence of recurrence or metastasis, during the follow-up periods ranging from 1 to 52 months.