Solid tumors of the cervicothoracic junction, the posterior mediastinum, or bilateral dorsal thoracic tumors represent a challenge in pediatric surgical oncology. The aim of this study was to evaluate trap-door thoracotomy and clamshell thoracotomy as surgical approaches. A single-center retrospective study of children with solid tumors in these specific localizations was performed. From 2015 to 2023, 26 children (17 girls; 9 boys) were treated at a median age of 54 months (range 8–229). Tumor resection was performed for neuroblastoma (n= 11); metastatic disease (n= 7); malignant rhabdoid tumor (n= 4); Ewing sarcoma (n= 1); inflammatory myofibroblastic tumor (n= 1); rhabdomyosarcoma (n= 1); and neurofibroma (n= 1). The surgical goal of macroscopic complete excision was achieved in all of the 14 children who underwent trap-door thoracotomy and in 11 of the 12 children who underwent clamshell thoracotomy. There were no major complications. At a median follow-up of 8 months (range 0–60), the disease was under local control or in complete remission in 66.7% of the children. In conclusion, surgical resection of solid tumors of the cervicothoracic junction in children can be performed safely and successfully with trap-door thoracotomy and with clamshell thoracotomy for posterior mediastinal or bilateral dorsal thoracic tumors.
颈胸交界处、后纵隔或双侧胸背部的实体肿瘤是小儿外科肿瘤学中的治疗难点。本研究旨在评估"活板门"式胸廓切开术与"蛤壳"式胸廓切开术作为手术入路的临床应用效果。我们对特定部位实体肿瘤患儿进行了单中心回顾性研究。2015年至2023年间，共26例患儿（17例女性，9例男性）接受治疗，中位年龄54个月（范围8-229个月）。肿瘤切除病理类型包括：神经母细胞瘤（11例）、转移性疾病（7例）、恶性横纹肌样瘤（4例）、尤文氏肉瘤（1例）、炎性肌纤维母细胞瘤（1例）、横纹肌肉瘤（1例）和神经纤维瘤（1例）。所有14例接受"活板门"式胸廓切开术的患儿及12例接受"蛤壳"式胸廓切开术患儿中的11例均实现了肉眼完全切除的手术目标。研究期间未发生重大并发症。中位随访8个月（范围0-60个月）后，66.7%的患儿疾病达到局部控制或完全缓解。结论表明，采用"活板门"式胸廓切开术可安全有效地切除儿童颈胸交界处实体肿瘤，而"蛤壳"式胸廓切开术适用于后纵隔或双侧胸背部肿瘤的外科切除。
肿瘤(癌症)患者之家