Xu Bing,Liu Wenying.Emphasis on surgical diagnosis and treatment of intrathoracic space occupying lesions in children[J].Journal of Clinical Pediatric Surgery,2025,(05):401-404.[doi:10.3760/cma.j.cn101785-202503071-001]
重视儿童胸腔内占位性疾病的外科诊治
- Title:
- Emphasis on surgical diagnosis and treatment of intrathoracic space occupying lesions in children
- Keywords:
- Thoracic; Space occupying Lesions; Diagnosis; Surgical Procedures; Operative; Child
- 摘要:
- 儿童胸腔内占位性疾病是小儿胸外科常见的一大类疾病，种类较多，临床表现多样，早期诊断和准确鉴别诊断对于制定合理的治疗方案至关重要。外科手术是治疗儿童胸腔内占位性疾病的主要手段，近年来儿童胸腔内占位性疾病的外科诊治取得了显著进展，但目前仍然存在一些规范性问题。对于许多类型的儿童胸腔内占位性疾病的手术指征尚未达成共识，缺乏统一的手术年龄标准，在手术方式选择上也存在争议。因此，临床需要进一步加强儿童胸腔内占位性疾病的早期诊断、规范化治疗和术后管理，以提高患儿的生存率和生活质量，促进儿童胸外科的健康发展。
- Abstract:
- Pediatric intrathoracic mass is a common group of diseases in pediatric thoracic surgery,encompassing a wide variety of types and diverse clinical manifestations.Early diagnosis and accurate differential diagnosis are essential for formulating an optimal treatment protocol.Surgery remains a primary treatment for for intrathoracic mass disease in children.In recent years,significant advances have been achieved in the surgical diagnosis and treatment of intrathoracic mass disease in children.However,there are still some standardization problems.No consensus is available on selecting surgical indications,there is a lack of a unified surgical age standard and controversy persists in selecting surgical approaches.It is imperative to further strengthen the early diagnosis,standardized treatment and postoperative management to improve the survival rate and quality of life of children and promote the development of pediatric thoracic surgery.
参考文献/References:
[1] Feng J,Zhao JL,Zhang YY,et al.Incidence,outcome and risk factors of perioperative pulmonary complications in pediatric patients with mediastinal mass[J].BMC Pediatr,2025,25(1):108.DOI:10.1186/s12887-025-05419-9.
[2] 中华医学会小儿外科学分会普胸外科学组，中国医疗保健国际交流促进会妇儿医疗保健分会.先天性肺气道畸形诊疗中国专家共识（2021版）[J].中华小儿外科杂志，2021,42(8):679-687.DOI:10.3760/cma.j.cn421158-20210112-00021. Section of General Thoracic Surgery,Branch of Pediatric Surgery,Chinese Medical Association,Branch of Women and Children’s Medical Care,China International Exchange and Promotive Association for Medical and Health Care.National expert consensus on diagnosis & treatment of congenital pulmonary airway malformations in China(2021)[J].Chin J Pediatr Surg,2021,42(8):679-687.DOI:10.3760/cma.j.cn421158-20210112-00021.
[3] Stocker JT.Cystic lung disease in infants and children[J].Fetal Pediatr Pathol,2009,28(4):155-184.DOI:10.1080/15513810902984095.
[4] 王莹，马立霜，刘超，等.先天性肺发育畸形产前诊断特点及新生儿期手术时机探讨[J].临床小儿外科杂志，2023,22(8):713-718.DOI:10.3760/cma.j.cn101785-202306042-003.Wang Y,Ma LS,Liu C,et al.Characteristics of prenatal diagnosis of congenital lung developmental malformation and timing of surgery during neonatal period[J].J Clin Ped Sur,2023,22(8):713-718.DOI:10.3760/cma.j.cn101785-202306042-003.
[5] 冯鑫，俞钢，夏波，等.新生儿肺部超声对先天性肺气道畸形的诊断价值[J].中华超声影像学杂志，2019,28(11):945-950.DOI:10.3760/cma.j.issn.1004-4477.2019.11.005.Feng X,Yu G,Xia B,et al.Application of neonate lung ultrasound in congenital pulmonary airway malformation[J].Chin J Ultrasonogr,2019,28(11):945-950.DOI:10.3760/cma.j.issn.1004-4477.2019.11.005.
[6] Valentini LG,Saletti V,Moscatelli M,et al.Which type of duraplasty is best for Chiari type I malformation surgery?[J].Neurosurg Focus,2025,58(2):E13.DOI:10.3171/2024.11.FOCUS24710.
[7] 刘文英.先天性肺气道畸形的诊治与预后问题[J].中华小儿外科杂志，2021,42(4):289-293.DOI:10.3760/cma.j.cn421158-20201218-00755.Liu WY.Diagnostic,therapeutic and prognostic issues of congenital pulmonary airway malformation[J].Chin J Pediatr Surg,2021,42(4):289-293.DOI:10.3760/cma.j.cn421158-20201218-00755.
[8] 曹正浓，刘丹，王雅楠，等.儿童纵隔神经源性肿瘤单中心外科治疗经验[J].临床小儿外科杂志，2022,21(3):231-235.DOI:10.3760/cma.j.cn101785-202202010-006.Cao ZN,Liu D,Wang YN,et al.Surgical treatment of pediatric mediastinal neurogenic tumors:a single-center experience[J].J Clin Ped Sur,2022,21(3):231-235.DOI:10.3760/cma.j.cn101785-202202010-006.
[9] Zheng JT,Tang HJ,Xu HY,et al.Thoracoscopic versus open resection for symptomatic congenital pulmonary airway malformations in neonates:a decade- long retrospective study[J].BMC Pulm Med,2021,21(1):82.DOI:10.1186/s12890-021-01445-2.
[10] Rothenberg SS.Thoracoscopic lobectomy in infants and children[J].J Laparoendosc Adv Surg Tech A,2021,31(10):1157-1161.DOI:10.1089/lap.2021.0454.
[11] Wu YJ,Zeng Q,Chen CH,et al.Thoracoscopy in paediatric patients with mediastinal lymphangiomas:10 years of surgical experience in a single centre[J].Pediatr Surg Int,2024,41(1):20.DOI:10.1007/s00383-024-05906-7.
[12] Jiang B,Tan QY,Deng B,et al.Robot- assisted thymectomy in large anterior mediastinal tumors:a comparative study with video- assisted thymectomy and open surgery[J].Thorac Cancer,2023,14(3):267-273.DOI:10.1111/1759-7714.14744.
[13] Zeng Q,Chen CH,Zhang N,et al.Robot-assisted thoracoscopic surgery for mediastinal tumours in children:a single- centre retrospective study of 149 patients[J].Eur J Cardiothorac Surg,2023,64(5):ezad362.DOI:10.1093/ejcts/ezad362.
[14] Huerta CT,Ramsey WA,Courel SC,et al.Nationwide outcomes after thoracoscopic versus open resection of congenital pulmonary airway malformations in newborns[J].J Laparoendosc Adv Surg Tech A,2023,33(9):897-903.DOI:10.1089/lap.2023.0010.
[15] Uppala R,Udomdirekkul P,Niamsanit S,et al.Clinical outcomes after surgical resection in asymptomatic and symptomatic children with congenital lung malformations[J].J Cardiothorac Surg,2025,20(1):126.DOI:10.1186/s13019-025-03372-3.
[16] Godard F,Haffreingue A,Hameury F,et al.Pulmonary consequences of surgical treatment in children’s primary lung tumors:a national retrospective study[J].Pediatr Blood Cancer,2025,72(3):e31522.DOI:10.1002/pbc.31522.
[17] Yoshida KI,Yoshida A.Sarcoma of the lung and mediastinum[J].Surg Pathol Clin,2024,17(2):243-255.DOI:10.1016/j.path.2023.11.008.
[18] Kesler KA,Stram AR,Timsina LR,et al.Outcomes following surgery for primary mediastinal nonseminomatous germ cell tumors in the cisplatin era[J].J Thorac Cardiovasc Surg,2021,161(6):1947-1959.e1.DOI:10.1016/j.jtcvs.2020.01.118.
相似文献/References:
[1]陈子民 叶明 夏永杰. 经胸腔入路与经胸膜外入路手术治疗Ⅲb型食管闭锁疗效观察[J].临床小儿外科杂志,2011,10(06):445.
[J].Journal of Clinical Pediatric Surgery,2011,10(05):445.
[2]王贤书 程征海 杨志国. 小儿脓胸402例临床分析[J].临床小儿外科杂志,2014,13(03):211.
[3]刘叶,王贤书,曹红宾,等.小儿脓胸的病原学特征与治疗探讨[J].临床小儿外科杂志,2017,16(05):499.
备注/Memo
收稿日期:2025-3-20。
基金项目:四川省科技厅重点项目（2021YFS0381）; 成都市科技局课题(2024-YF05-01871-SN)
通讯作者:刘文英，Email:wenyingl@126.com