同期双侧单孔胸腔镜手术治疗胸腺瘤合并重症肌无力

目的探讨同期双侧单孔胸腔镜下胸腺扩大切除术的可行性及早期手术效果。方法2017年8月~2019年6月,对20例胸腺瘤合并重症肌无力行同期双侧单孔胸腔镜下胸腺扩大切除术。切口位于腋前线和腋中线之间第4肋间,长3 cm。结果手术均顺利完成,手术时间(183.2±27.8)min,术中失血量(36.0±27.2)ml,胸腔引流时间(3.9±1.1)d,术后住院时间(6.1±1.4)d,病理测量瘤体最大径(4.3±1.3)cm。无围手术期并发症。Masaoka分期Ⅰ期2例,Ⅱ期16例,Ⅲ期2例(B2型和B3型各1例)。20例随访2~24个月,中位数14个月,总体缓解率90%(18/20)。结论同期双侧单孔胸腔镜下胸腺扩大切除术治疗胸腺瘤合并重症肌无力,手术安全,近期效果满意。

Bilateral Uniportal Thoracoscopic Surgery for Thymoma With Myasthenia Gravis

Objective To evaluate the feasibility of bilateral uniportal thoracoscopic extended thymectomy and early clinical results of this technique.Methods Twenty patients with myasthenia gravis with thymoma underwent bilateral uniportal thoracoscopic extended thymectomy from August 2017 to June 2019.The incision was 3 cm in lenth and located at the 4 th intercostal space between the anterior axillary line and the midaxillary line.Results The operation was successfully completed,the mean operative time was(183.2±27.8)min,the average blood loss was(36.0±27.2)ml,the chest tube duration was(3.9±1.1)days,the postoperative hospital stay was(6.1±1.4)days,and the tumor size measured by pathology was(4.3±1.3)cm.There were no operative deaths or perioperative complications.There were Masaoka stageⅠin 2 cases,Ⅱin 16 cases,andⅢin 2 cases(B2 in 1 case and B3 in 1 case).Twenty patients were followed up for 2-24 months,with a median of 14 months.The overall remission rate was 90%(18/20).Conclusion Bilateral uniportal thoracoscopic extended thymectomy for thymoma with myasthenia gravis is a safe and promising technique with regard to short-term clinical outcome.