充气式剑突下单孔胸腔镜手术治疗胸腺肿瘤

Inflatable Subxiphoid Single-port Video-assisted Thoracoscopic Surgery for Thymal Tumors

目的探讨充气式剑突下单孔胸腔镜手术治疗胸腺肿瘤的可行性和安全性。方法2020年3月~2021年5月我科对20例胸腺肿瘤行充气式剑突下单孔胸腔镜手术,在剑突下2 cm做3 cm横行切口,应用单孔套管穿刺器行充气式单孔胸腔镜手术完整切除胸腺肿瘤。结果20例顺利完成充气式剑突下单孔胸腔镜手术,无中转开胸或增加辅助切口。手术时间平均110 min(60~150 min),出血量平均50 ml(10~80 ml)。前8例胸腔闭式引流管引流平均时间1.5 d(1~3 d),后12例未放引流管。术后病理:胸腺瘤13例,胸腺囊肿5例,胸腺增生2例。20例术后随访1~12个月,中位随访时间6个月,无复发及其他并发症。结论单孔套管穿刺器行充气式剑突下单孔胸腔镜手术治疗胸腺肿瘤简单易行,安全可靠。

Objective To explore the feasibility and safety of inflatable subxiphoid single-port video-assisted thoracoscopic surgery in the treatment of thymal tumors.Methods Clinical data of 20 cases of thymal tumors in our hospital from March 2020 to May 2021 were retrospectively analyzed.A 3 cm transverse incision was made 2 cm below the xiphoid process,and a single-hole cannula puncture apparatus was applied to carry out inflatable subxiphoid single-port video-assisted thoracoscopic surgery for thymal tumors.Results All the 20 patients underwent inflatable subxiphoid single-port video-assisted thoracoscopic surgery successfully.There was no conversion to thoracotomy or additional assisted incision.Postoperative pathological examination showed 13 cases of thymoma,5 cases of thymic cyst and 2 cases of thymic hyperplasia.The average operative time was 110 min(range,60-150 min).The average blood loss was 50 ml(range,10-80 ml).The average drainage time of closed thoracic drainage tube was 1.5 d(range,1-3 d)in 8 cases in the first 8 cases,and no drainage tube was placed in the last 12 cases.Postoperative follow-ups lasted for 1-12 months(median,6 months).There was no relapsing or other complications.Conclusion Treatment of thymal tumors with inflatable subxiphoid single-port video-assisted thoracoscopic surgery is simple to practice,safe and reliable.