Chen Ming,He Min,Wu Xuan,et al.Application value of Trapdoor surgical approach for pediatric neuroblastoma at cervicothoracic junction[J].Journal of Clinical Pediatric Surgery,2026,(04):310-315.[doi:10.3760/cma.j.cn101785-20260309-00101]
Trapdoor手术入路治疗儿童颈胸交界处神经母细胞瘤的应用价值
- Title:
- Application value of Trapdoor surgical approach for pediatric neuroblastoma at cervicothoracic junction
- Keywords:
- Neuroblastoma; Cervicothoracic Junction Tumor; Surgical Procedure; Trapdoor Surgical Approach; Children; Treatment Outcome
- 摘要:
- 目的 探讨并评估Trapdoor手术入路治疗儿童颈胸交界处神经母细胞瘤的技术要点、安全性及临床应用价值。方法 本研究为回顾性研究。回顾性分析2018年1月至2025年12月浙江大学医学院附属儿童医院采用Trapdoor手术入路治疗的颈胸交界处神经母细胞瘤患儿临床及病理资料。收集手术相关指标及术后并发症情况,通过门诊及电话随访,收集患儿随访时间以及生存结局。结果 本研究共纳入72例患儿,其中男23例(31.9%)、女49例(68.1%),年龄6个月18天至10岁9个月。均顺利完成手术,且达到肉眼全切。手术时间(4.77±2.20)h,术中出血(104.11±131.20)mL;纵隔负压引流管留置时间(7.40±2.72)d,术后住院时间(10.69±5.48)d。17例(17/72,23.6%)术后出现并发症,主要为声音嘶哑、肺炎、肺不张等。随访期间,61例存活,13例(13/72,18.1%)出现病情进展或复发(7例发生于手术部位,6例发生于非手术部位);11例(11/72,15.3%)死亡,其中8例死于疾病进展,3例死于化疗后重度骨髓抑制引起的严重感染;无一例因手术并发症致死亡。结论 Trapdoor手术入路治疗儿童颈胸交界处神经母细胞瘤,可获得较高的肉眼全切率,近期安全性良好;长期预后总体较好,但存在并发症风险。建议加强围手术期精细化管理与术后随访,以改善患儿远期生存结局。
- Abstract:
- Objective To evaluate the technical essentials,safety and clinical application value of Trapdoor surgical approach for neuroblastoma at cervicothoracic junction in children.Methods From January 2018 to December 2025,the relevant clinicopathological data were retrospectively reviewed for 72 children with neuroblastoma at cervicothoracic junction operated via a Trapdoor approach.Surgical-related parameters and postoperative complications were recorded.And the follow-up data of survival outcomes were gathered through outpatient and telephone follow-ups.Results There were 23 boys (31.9%) and 49 girls (68.1%) with an age range from 6 months and 18 days to 10 years and 9 months.All operations were successfully completed with gross total resection.Average operative duration was (4.77±2.20) hours and intraoperative blood loss (104.11±131.20) ml.Median duration of mediastinal negative pressure drainage tubing was (7.40±2.72) day and postoperative hospital stay (10.69±5.48) day.Postoperative complications occurred (17/72,23.6%),primarily including hoarseness,pneumonia and atelectasis.During follow-ups,61 cases survived while 13 cases (13/72,18.1%) experienced disease progression or recurrence (7 cases at surgical site and 6 cases at non-surgical sites).Among 11 deaths (11/72,15.3%),the causes were disease progression (n=8) and severe infections from hemotherapy-induced severe bone marrow suppression (n=3).No death was caused by surgical complications.Conclusions For neuroblastoma at cervicothoracic junction in children,Trapdoor approach achieves a high gross total resection rate and demonstrates excellent short-term safety.Its long-term prognosis is generally favorable.However,complications remain frequent.Enhanced perioperative meticulous management and postoperative follow-ups are essential for improving long-term survival outcomes in children.
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备注/Memo
收稿日期:2026-3-15。
基金项目:国家自然科学基金委面上项目(32270853);浙江省"尖兵领雁+X"科技计划项目(2025C01106);浙江省"尖兵""领雁"研发攻关计划项目(2024C03181)
通讯作者:王金湖,Email:wjh@zju.edu.cn