Myasthenia gravies is a common disease in the clinic. Extended thymectomy is an important way to treat myasthenia gravis. Median thoracotomy, thoracoscopy, and robots are important surgical methods. Da Vinci robot-assisted thoracoscopic surgery is more and more widely used in extended thymectomy, with high surgical safety and good stability. The surgical approach includes intercostal approach, subxiphoid approach, etc. Different surgical approaches have their own advantages, and their surgical effects are different. This article introduces the indications, technical steps, and effects of da Vinci robot-assisted thoracoscopic surgery, analyzes the advantages and limitations of treating myasthenia gravis, and looks forward to its development prospects.
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。