胸腔镜胸腺扩大切除术的方法和效果分析

目的探讨电视胸腔镜(VATS)下胸腺扩大切除术治疗重症肌无力(MG)的手术方法和效果。方法 52例重症肌无力合并胸腺瘤或者单纯胸腺增生的患者在胸腔镜下完成胸腺瘤、胸腺扩大切除术。结果手术均在VATS下完成,无中转开胸者,无严重围手术期并发症,其中胸腺增生45例,胸腺瘤7例。随访6～12个月,完全缓解6例,部分缓解42例,无效4例。结论 MG患者行VATS胸腺瘤、胸腺扩大切除术安全、可行,效果理想,值得临床推广。

Surgery approach and effectiveness of video-assisted thoracoscopic(VATS) extended thymectomy

Objective To discuss the surgery approach and effectiveness of video-assisted thoracoscopic(VATS)extended thymectomy. Methods Clinical data of 52 myasthenia gravis(MG) patients with thymoma or simple thymus hyperplasia treated by VATS were reviewed retrospectively. Results VATS excision of thymoma was performed in 7 patients, extended thymectomy were performed in 45 patients. None was converted to thoracoectomy. The operation time was 55～150 min( 80 min in average). The blood loss was during the procedure was 50～200 ml(120 ml in average). The time of chest tube implementation was 1～3 d. The hospitalization length after surgery was 3～5 days. No intra or post-operative death or complications were reported. No myasthenia gravity crisis occurred. The follow-up period after operation was 6～12 months. Six patients achieved complete relief, 42 patients achieved partial relief, the other 4 patients kept stable. Conclusions Excision of thymoma and extended thymectomy by VATS is safe and effective, therefore it is a preferred choice for patients with myasthenia gravis.