临床小儿外科杂志2024，Vol.23Issue(12)：1160-1165,6.DOI:10.3760/cma.j.cn101785-202403033-010
椎管病灶切除在合并椎管内侵犯的椎旁肿瘤治疗中的应用:单中心75例报告
Managements of paravertebral tumors with spinal canal involvement in children:a report of 75 cases at a single center
摘要
Abstract
Objective To explore the clinical diagnoses and treatments of paravertebral tumors plus spinal canal involvement(SCI)and evaluate the safety of intraspinal lesion resection and the effectiveness of tumor local control.Methods For this retrospective study,the relevant clinical data were reviewed for 75 childrens with pa-ravertebral tumors plus SCI undergoing intraspinal lesion resection from April 2015 to March 2023.Pathological types,neurological function outcomes,incidence of scoliosis and local tumor control were recorded and the sub-group of neuroblastoma patients with the highest proportion was statistically examined.Results There were neu-roblastoma(n=53)and other tumors(n=22).There were no preoperative neurological symptoms(Group A,n=34),mild neurological dysfunction(Group B,n=26)and severe neurological dysfunction(Group C,n=15).In Group A,7(7/34)of transient postoperative neurological dysfunction normalized in the long term.In Group B,neurological dysfunction worsened immediately post-operation(n=2),21(21/26)had significant long-term improvement in neurological function and 5/26 showed no significant improvement.In Group C,12(12/15)had marked postoperative improvement in neurological function and normalized(n=2).Analysis based upon sur-gical timing,improvement rate of neurological function was higher in emergency surgery group than that in non-e-mergency surgery group with statistically significant differences(P=0.038).Among 13 cases of postoperative scoliosis,scoliosis pre-existed(n=3)and grade was Ⅰ(n=6),Ⅱ(n=5)and Ⅲ(n=2).Among 10 cases of neu-roblastoma,scoliosis pre-existed(n=2)and grade was Ⅰ(n=5)and Ⅱ(n=5).Residue or recurrence occurred in 3.8％(2/53).Conclusions In children with paravertebral tumors plus SCI,resection of intraspinal lesions is essential for protecting neurological function and achieving excellent local tumor control.Based upon modern sur-gical techniques and monitoring technology,intraspinal lesion resection is both safe and feasible.关键词
椎旁,肿瘤/神经母细胞瘤/椎管/肿瘤转移/外科手术/转移瘤切除术/治疗结果Key words
Paraspinal,Neoplasms/Neuroblastoma/Spinal Canal/Neoplasm Metastasis/Surgical Pro-cedures,Operative/Metastasectomy/Treatment Outcome引用本文复制引用
王棋,王金湖,唐银炳,李雅雯,姬兆年,丁浙玉,舒强..椎管病灶切除在合并椎管内侵犯的椎旁肿瘤治疗中的应用:单中心75例报告[J].临床小儿外科杂志,2024,23(12):1160-1165,6.基金项目
浙江省尖兵领雁研发攻关计划项目(2024CO3181) Grant of Pioneering R&D Program of Zhejiang Province(2024CO3181) （2024CO3181）
