电视胸腔镜经右胸前侧径路胸腺切除治疗重症肌无力

Video-assisted Thoracoscopic Thymectomy Through Right Anterior Lateral Approach to Treat Myasthenia Gravis

目的 探讨电视胸腔镜手术 (VATS)胸腺切除治疗重症肌无力的效果。 方法 10例重症肌无力患者采用 VATS经右胸前侧径路行胸腺切除及纵隔脂肪清扫 (VATS组 ) ,并与 2 0例胸骨劈开胸腺切除 (胸骨劈开组 )相对照。 结果 VATS组中 9例顺利完成手术 ,1例因电凝钩伤及头臂静脉干而中转开胸止血 ;全组无术后死亡及危象发生 ;手术时间、术后住院时间均较胸骨劈开组明显缩短。 结论 VATS经右胸前侧径路行完全胸腺切除是可行的 ,且具有创伤小、恢复快等优点 ,可在临床进一步应用。

ObjectiveTo explore the effect of video-assisted thoracoscopic surgery (VATS) thymectomy in treatment of myasthenia gravis (MG). MethodsTen patients with MG underwent thoracoscopic thymectomy and mediastinal fat dissecting through right anterior lateral approach (VATS group) and were compared with 20 MG patients who received transsternal thymectomy (conventional median sternotomy group).ResultsNine patients had complete thymectomy smoothly in the VATS group and 1 required thoracotomy because the brachiocephalic vein was injured by the claw of electric coagulator. There were no postoperative deaths or MG crisis. The operative time and postoperative hospital stay were significantly shorter in the VATS group than in the conventional median sternotomy group.ConclusionsVATS thymectomy through right anterior lateral approach is technically feasible and has the advantages of less trauma and rapid recovery.