Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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One Stage Posterior Minimal Laminectomy and Video-Assisted Thoracoscopic Surgery (VATS) for Removal of Thoracic Dumbbell Tumor

  • Nam, Kyoung Hyup (Department of Neurosurgery, Medical Research Institute, Pusan National University Hosptial) ;
  • Ahn, Hyo Yeoung (Department of Thoracic and Cardiovascular surgery, Medical Research Institute, Pusan National University Hosptial) ;
  • Cho, Jeong Su (Department of Thoracic and Cardiovascular surgery, Medical Research Institute, Pusan National University Hosptial) ;
  • Kim, Yeoung Dae (Department of Thoracic and Cardiovascular surgery, Medical Research Institute, Pusan National University Hosptial) ;
  • Choi, Byung Kwan (Department of Neurosurgery, Medical Research Institute, Pusan National University Hosptial) ;
  • Han, In Ho (Department of Neurosurgery, Medical Research Institute, Pusan National University Hosptial)
  • Received : 2016.09.26
  • Accepted : 2016.12.23
  • Published : 2017.03.01
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Abstract

Objective : This study was conducted to assess the surgical results of one-stage posterior minimal laminectomy and video-assisted thoracoscopic surgery (VATS) for the treatment of thoracic dumbbell tumor and to describe its precise technique. In addition, we investigated the technique's usefulness and limitations. Methods : Seven cases of thoracic dumbbell tumor (two men and five women, mean age, 43 years) were analyzed retrospectively. Pathological findings included schwannoma in four patients, neurofibroma in two patients, and hemangioma in one patient. The location of tumors varied from T2/3 to T12/L1. Dumbbell tumors were resected by one-stage operation using posterior laminectomy followed by VATS without instrumentation. Clinical data were reviewed. Results : The mean follow-up period was 25 months (range, 3-58 months), and the operative time ranged from 255 to 385 min (mean, 331 min), with estimated blood loss ranging from 110 to 930 mL (mean, 348 mL). The tumor was completely resected without instrumentation and postoperative instability in all cases. Postoperative complications included atelectasis and facial anhydrosis in one case each. Conclusion : One-stage posterior minimal laminectomy and VATS may be a safe and less invasive technique for removal of thoracic dumbbell tumor without instability. This method has the advantage of early ambulation and rapid recovery because it reduces blood loss and postoperative pain.

Keywords

References

  1. Ando K, Imagama S, Ito Z, Tauchi R, Muramoto A, Matsui H, et al. : Removal of thoracic dumbbell tumors through a single-stage posterior approach : its usefulness and limitations. J Orthop Sci 18 : 380-387, 2013 https://doi.org/10.1007/s00776-013-0370-9
  2. Ando K, Imagama S, Wakao N, Hirano K, Tauchi R, Muramoto A, et al. : Single-stage removal of thoracic dumbbell tumors from a posterior approach only with costotransversectomy. Yonsei Med J 53 : 611-617, 2012 https://doi.org/10.3349/ymj.2012.53.3.611
  3. Hurley JP, McCarthy J, Wood AE : Retrospective analysis of the utility of video-assisted thoracic surgery in 100 consecutive procedures. Eur J Cardiothorac Surg 8 : 589-592, 1994 https://doi.org/10.1016/1010-7940(94)90041-8
  4. Jeon JH, Kang CH, Kim HS, Seong YW, Park IK, Kim YT, et al. : Videoassisted thoracoscopic lobectomy in non-small-cell lung cancer patients with chronic obstructive pulmonary disease is associated with lower pulmonary complications than open lobectomy : a propensity scorematched analysis. Eur J Cardiothorac Surg 45 : 640-645, 2014 https://doi.org/10.1093/ejcts/ezt460
  5. Jeong WJ, Choi I, Seong HY, Roh SW : Thoracic extradural cavernous hemangioma mimicking a dumbbell-shaped tumor. J Korean Neurosurg Soc 58 : 72-75, 2015 https://doi.org/10.3340/jkns.2015.58.1.72
  6. Eden K : The dumbbell tumours of the spine. Br J Surg 28 : 549-570, 1941 https://doi.org/10.1002/bjs.18002811205
  7. Konno S, Yabuki S, Kinoshita T, Kikuchi S : Combined laminectomy and thoracoscopic resection of dumbbell-type thoracic cord tumor. Spine (Phila Pa 1976) 26 : E130-E134, 2001 https://doi.org/10.1097/00007632-200103150-00005
  8. Ozawa H, Kokubun S, Aizawa T, Hoshikawa T, Kawahara C : Spinal dumbbell tumors : an analysis of a series of 118 cases. J Neurosurg Spine 7 : 587-593, 2007 https://doi.org/10.3171/SPI-07/12/587
  9. Payer M, Radovanovic I, Jost G : Resection of thoracic dumbbell neurinomas : single postero-lateral approach or combined posterior and transthoracic approach? J Clin Neurosci 13 : 690-693, 2006 https://doi.org/10.1016/j.jocn.2005.09.010
  10. Shiraishi T, Hida S, Isayama T, Yoneda S, Kawahara K, Shirakusa T : A combined thoracoscopic and posterior-spinal approach for "dumbbell" neurofibroma minimizes the anatomical destruction of the vertebrae : report of a case. Surg Today 32 : 155-158, 2002 https://doi.org/10.1007/s005950200010
  11. Thorat JD, Rajendra T, Thirugnanam A, Ng IH : Single-stage posterior midline approach for dumbbell tumors of the thoracic spine, with intraoperative CT guidance. Surg Neurol Int 2 : 31, 2011 https://doi.org/10.4103/2152-7806.77272
  12. Vallieres E, Findlay JM, Fraser RE : Combined microneurosurgical and thoracoscopic removal of neurogenic dumbbell tumors. Ann Thorac Surg 59 : 469-472, 1995 https://doi.org/10.1016/0003-4975(94)00876-9

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