胸腔镜胸腺切除治疗重症肌无力6例

Video assisted thoracoscopic thymectomy for six cases of myasthenia gravis

目的探讨采用电视胸腔镜手术(VATS)行胸腺切除治疗重症肌无力的临床效果。方法自2004年2月至2005年12月,我们用此方法施行6例胸腺切除以治疗重症肌无力,其中3例伴有胸腺瘤。结果所有病例均完整切除胸腺及心前区脂肪组织,无术中并发症及死亡,均未输血,无一例发生重症肌无力危象。术后随访配合药物治疗,临床症状均有所改善。平均住院时间、术后镇痛药用量均比采用胸骨正中切开胸腺切除组少(P <0．05)。结论采用VATS技术行胸腺完整切除是可行的,且具有创伤小、恢复快的优点,但对重症肌无力的远期疗效尚有待病例的进一步累积及观察。

Objective To discuss the effect of thymectomy supported by video assisted thoracoscopic surgery （VATS） to treat myasthenia gravis （MG）. Methods From February 2004 to December 2005, VATS was applied in thymectomy for six cases. Resnlts Complete thymectomy was achieved in every case. There was no death and complication in operation. Average hospital stay was 5.2 days. Compared with the conventional median sternotomy, VATS had shorter postoperative hospital stay and less analgesic requirement. Conclusion VATS thymectomy is technically feasible. However, the long-term effect of VATS in the treatment of MG requires further study.