Clinical analysis of trans-subxiphoid thoracoscopic approach for performing extended thymectomy in patients with myasthenia gravis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 周一凡 , 鐘永瀧 , 林輝 , 李香偉 , 溫昭科 , 龍小毛

廣西壯族自治區人民醫院心胸外科（南寧 530021）;

Corresponding?author：

周一凡, Email: richbeijing@163.com

Keywords：

重癥肌無力; 胸腔鏡; 劍突入路; 胸腺切除

DOI：

10.7507/1007-4848.201604058

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探討結合肋緣下切口的劍突入路胸腔鏡胸腺擴大切除治療重癥肌無力的手術安全性與臨床療效。方法回顧性分析 2015 年 10 月至 2016 年 4 月期間我院心胸外科收治的 23 例重癥肌無力合并胸腺疾病患者的臨床資料。其中男 8 例、女 15 例，年齡 11～70（40.70±17.31）歲。所有患者采用經劍突入路胸腔鏡胸腺擴大切除手術。結果所有手術均成功，無中轉開胸或延長手術切口長度患者。患者切口長度平均（2.76±0.40）cm，手術時間平均（138.4±35.4）min，術中出血量平均（35.2±28.6）ml，術后呼吸機輔助時間平均（13.40±9.84）h，采用延遲拔管 1 例，術后并發癥 2 例，其中少量胸腔積液 1 例、肺炎 1 例。術后疼痛視覺模擬（VAS）評分平均 2.77 分。結論劍突入路胸腔鏡胸腺擴大切除技術是安全可行的手術方式，具有容易操作、清掃徹底、手術創傷小、恢復快、美容效果好等優點，值得深入研究及進一步推廣。

Citation： 周一凡, 鐘永瀧, 林輝, 李香偉, 溫昭科, 龍小毛. Clinical analysis of trans-subxiphoid thoracoscopic approach for performing extended thymectomy in patients with myasthenia gravis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(4): 318-320. doi: 10.7507/1007-4848.201604058 Copy

1.	?Raza A, Woo E.Video-assisted thoracoscopic surgery versus sternotomy in thymectomy for thymoma and myasthenia gravis. Ann Cardiothorac Surg, 2016, 5(1): 33-37.
2.	Sugarbaker DJ. Thoracoscopy in the management of anterior mediastinal masses. Ann Thorac Surg, 1993, 56(3): 653-656.
3.	張毅, 支修益, 許慶生, 等. 電視胸腔鏡下擴大胸腺切除治療重癥肌無力. 中國胸心血管外科臨床雜志, 2008, 15(6): 473-474.
4.	Xie A, Tjahjono R, Phan K, et al. Video-assisted thoracoscopic surgery versus open thymectomy for thymoma: a systematic review. Ann Cardiothorac Surg, 2015, 4(6): 495-508.
5.	Hsu CP, Chuang CY, Hsu NY, et al. Subxiphoid approach for video-assisted thoracoscopic extended thymectomy in treating myasthenia gravis. Interact Cardiovasc Thorac Surg, 2002, 1(1): 4-8.
6.	周一凡, 賀榜福, 梁勝景, 等. 40 例胸腺瘤合并重癥肌無力的外科治療. 中國醫藥指南, 2012, 10(3): 32-33.
7.	Donahoe L, Keshavjee S. Video-assisted transcervical thymectomy for myasthenia gravis. Ann Cardiothorac Surg, 2015, 4(6): 561-563.
8.	胡牧, 張毅, 支修益. 電視胸腔鏡下擴大胸腺切除治療重癥肌無力. 中國胸心血管外科臨床雜志, 2008, 15(6): 473-474.
9.	Suda T, Tochii D, Tochii S, et al. Trans-subxiphoid robotic thymectomy. Interact Cardiovasc Thorac Surg, 2015, 20(5): 669-671.
10.	張國瑜, 張雙林, 張清勇, 等. 經劍突下單孔胸腔鏡治療雙側胸部疾病. 中華實驗外科雜志, 2015, 32(10): 2581-2582.
11.	Suda T, Ashikari S, Tochii D, et al. Dual-port thymectomy using subxiphoid approach. Gen Thorac Cardiovasc Surg, 2014, 62(9): 570-572.
12.	Suda T, Hachimaru A, Tochii D, et al. Video-assisted thoracoscopic thymectomy versus subxiphoid single-port thymectomy: initial resultsdagger. Eur J Cardiothorac Surg, 2016, 49(Suppl 1): i54-i58.

1. ?Raza A, Woo E.Video-assisted thoracoscopic surgery versus sternotomy in thymectomy for thymoma and myasthenia gravis. Ann Cardiothorac Surg, 2016, 5(1): 33-37.
2. Sugarbaker DJ. Thoracoscopy in the management of anterior mediastinal masses. Ann Thorac Surg, 1993, 56(3): 653-656.
3. 張毅, 支修益, 許慶生, 等. 電視胸腔鏡下擴大胸腺切除治療重癥肌無力. 中國胸心血管外科臨床雜志, 2008, 15(6): 473-474.
4. Xie A, Tjahjono R, Phan K, et al. Video-assisted thoracoscopic surgery versus open thymectomy for thymoma: a systematic review. Ann Cardiothorac Surg, 2015, 4(6): 495-508.
5. Hsu CP, Chuang CY, Hsu NY, et al. Subxiphoid approach for video-assisted thoracoscopic extended thymectomy in treating myasthenia gravis. Interact Cardiovasc Thorac Surg, 2002, 1(1): 4-8.
6. 周一凡, 賀榜福, 梁勝景, 等. 40 例胸腺瘤合并重癥肌無力的外科治療. 中國醫藥指南, 2012, 10(3): 32-33.
7. Donahoe L, Keshavjee S. Video-assisted transcervical thymectomy for myasthenia gravis. Ann Cardiothorac Surg, 2015, 4(6): 561-563.
8. 胡牧, 張毅, 支修益. 電視胸腔鏡下擴大胸腺切除治療重癥肌無力. 中國胸心血管外科臨床雜志, 2008, 15(6): 473-474.
9. Suda T, Tochii D, Tochii S, et al. Trans-subxiphoid robotic thymectomy. Interact Cardiovasc Thorac Surg, 2015, 20(5): 669-671.
10. 張國瑜, 張雙林, 張清勇, 等. 經劍突下單孔胸腔鏡治療雙側胸部疾病. 中華實驗外科雜志, 2015, 32(10): 2581-2582.
11. Suda T, Ashikari S, Tochii D, et al. Dual-port thymectomy using subxiphoid approach. Gen Thorac Cardiovasc Surg, 2014, 62(9): 570-572.
12. Suda T, Hachimaru A, Tochii D, et al. Video-assisted thoracoscopic thymectomy versus subxiphoid single-port thymectomy: initial resultsdagger. Eur J Cardiothorac Surg, 2016, 49(Suppl 1): i54-i58.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of trans-subxiphoid thoracoscopic approach for performing extended thymectomy in patients with myasthenia gravis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content