26例胸腺瘤外科治疗经验

目的回顾总结26例胸腺瘤外科治疗经验。万法全鄙米用胸骨正中切口，完整训际22例，姑思性切除2例，单纯活检2例。17例接受术后放射治疗，3例术后同时接受放疗及化疗。结果本组无手术死亡，术后无肌无力危象发生，症状明显缓解／消失21例。除3例病人失访外，1例姑息性切除者术后3月肿瘤复发，3例术后1月重症肌无力症状复发或加重。结论患者易有多种伴瘤症状而使临床表现呈现多样化，手术有望改善或消除这些症状。手术治疗是目前治疗胸腺瘤的首选方式，完整切除肿瘤是提高手术疗效的关键。伴发重症肌无力症状者要重视围手术期处理。多学科综合治疗在胸腺瘤的治疗中日益受到重视。

Surgical treatment of thymoma (report of 26 cases)

Objective To review and summarize 26 cases of thymoma underwent surgical treatment. Methods All the patients underwent complete media sternotomy, of which 22 cases of total thymectomy with anterior mediastinal fatty tissue resection ,2 cases of partial resection and 2 cases of biopsy were performed respectively, 20 patients were received a multimodal treatment regimen postoperatively: radiotherapy for 17 cases , radiotherapy plus chemotherapy for 3 cases. Results There was no death occurred perioperatively and no myasthenic crisis occurred postoperatively, 21 cases got a favorable effect. Besides 3 patients lost follow-up, tumor relapsed in 1 case who underwent partial resection and myasthenia gravis reoccurred or exacerbated in 3 cases. Conclusion Clinical manifestation of thymoma is diverse because of the variety of paraneoplastic syndromes which can be eliminated by operation. Surgical removal is the cornerstone of therapy for thymoma ,and complete resection of lesion and its adjacent tissue in anterior mediastinum is the critical factor in improving curative effect. Attention must be paid for those who have myasthenia gravis. The combined multidisciplinary treatment for thymoma is of importance and widely accepted.