胸腺瘤合并重症肌无力双侧胸腔镜胸腺扩大切除术

摘要

目的 探讨双侧胸腔镜下胸腺扩大切除术的可行性及早期手术效果.方法 2014年7月至2016年1月期间23例胸腺瘤合并重症肌无力患者接受双侧胸腔镜下胸腺扩大切除术.两个手术操作孔分别选择在腋前线第3肋间和锁骨中线第4肋间,10 mm 30°胸腔镜孔在腋中线第6肋间.收集和回顾性分析围手术期变量和结果.结果 患者手术时间(163.2±14.4) min,术中失血量(148.2±39.5) ml,带胸腔闭式引流管(4.14-0.27)天.无手术死亡,术后30天内无并发症.结论 双侧胸腔镜下胸腺扩大切除术治疗胸腺瘤合并重症肌无力,手术安全,近期效果满意.%Objective To present the technique of super-minimally invasive bilateral thoracoscopic extended thymectomy,and evaluate the early clinical results by using of this technique.Methods Twenty-three patients with myasthenia gravis (MG) with thymoma underwent with super-minimally invasive bilateral thoracoscopic extended thymectomy in our institution between July 2014 and January 2016.Two operate-poles are 5mm trocar,one is three intercostal space at the anterior axillary line,and the other is four intercostal space at the midclavicular line.A 10 mm trocar is inserted through the 6th intercostal space in the mid axillary line.The perioperative variables and outcomes were collected and analysed retrospectively.Results In the 23 patients who underwent Super-Minimally invasive bilateral thoracoscopic extended thymectomy,the mean operation time was (163.2 ± 14.4) min and the average blood loss was (148.2 ± 39.5) ml.The chest tube duration was (4.14 ± 0.27) days.There were no mortalities.Conclusion Our preliminary report showed that Super-Minimally invasive bilateral thoracoscopic extended thymectomy for mediastinal tumour resection was a promising and safe technique with regard to short-term clinical outcome.