Objective To evaluate the application value of the VATS combined with artificial pneumothorax in extended thymectomy. Methods From March 2013 to November 2014, we completed 45 cases of expanded thymectomy in patients with myasthenia gravis .According to the choice of patients , the surgeries were divided into two groups .The artificial pneumothorax group (24 cases) was given thoracoscopic expanded resection under artificial pneumothorax , while the conventional surgery group (21 cases) was given conventional thoracoscopic surgery .The operation time , intraoperative bleeding , operative field show ( to expose the offside mediastinal fat and cardiophrenic angle fat fully ) and symptom relief were compared between the two groups . Results The operations were successful in all the 45 cases.As compared with the conventional surgery group , the artificial pneumothorax group had shorter operation time [(93.8 ±16.8) min vs.(119.5 ±23.3) min, t=-4.293, P=0.000], less intraoperative hemorrhage [(54.2 ±43.7) ml vs.(92.9 ±41.0) ml, t=-3.048, P=0.004] and better operation exposure [91.7% (22/24) vs.57.1%(12/21),χ2 =7.228, P=0.007].However, there was no significant difference in symptom remission rate between the two groups . Conclusion VATS under artificial pneumothorax for thymus expanded resection can fully expose the operation field , with shorter operation time and less blood loss .%目的：探讨胸腔镜联合人工气胸在胸腺扩大切除术中的应用价值。方法2013年3月～2014年11月，对45例重症肌无力行胸腺扩大切除术。根据患者意愿选择术式，24例全胸腔镜联合人工气胸下手术，21例常规胸腔镜手术。比较2组手术时间、术中出血、术野显露（对侧纵隔脂肪及心膈角脂肪暴露清楚为显露满意）、症状缓解情况。结果45例均手术成功，与常规组相比，人工气胸组手术时间短[（93．8±16．8） min vs．（119．5±23．3） min， t＝－4．293， P＝0．000]，术中出血少[（54．2±43．7） ml vs．（92．9±41．0） ml， t ＝－3．048， P＝0．004]，术野显露好[91．7%（22／24） vs．57．1%（12／21），χ2＝7．228， P＝0．007]，症状缓解率无显著差异。结论经胸腔镜联合人工气胸在胸腺扩大切除术中具有手术视野暴露充分、手术时间短、出血量少的优点。
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