胸骨悬吊剑突下途径与肋间入路胸腔镜胸腺切除术的临床对比研究

Comparative analysis of the clinical outcomes of thoracoscopic thymectomy with sternal suspension under xiphoid process and intercostal approach in thymic diseases

目的:分析胸骨悬吊剑突下胸腔镜途径胸腺切除术的临床疗效。方法:回顾性分析25例行胸骨悬吊剑突下途径与74例肋间入路胸腔镜胸腺切除术患者的临床资料,分析其手术时间、术后胸管引流量、术后住院时间、疼痛评分等情况间的差异。结果:剑突组与肋间组患者在年龄、性别、高血压、病灶长径、手术时间、术后引流量、疼痛评分方面差异均无统计学意义,而剑突组的淋巴结清扫个数多于肋间组,剑突组的术后住院时间短于肋间组,两者差异有统计学意义。结论:胸骨悬吊剑突下途径胸腔镜胸腺切除术治疗胸腺疾病更彻底,安全便捷,疗效满意,值得临床推广。

Objective:To analyze the clinical outcomes of thymus resection via subxiphoid process with suspension of sternum.Methods:The clinical data,including operative time,maintenance of postoperative chest tube drainage,days of postoperative hospital stay and pain score,were retrospectively analyzed in 25 patients undergone endoscopic thymus resection by subxiphoid approach with sternal suspension and 74 patients undergone intercostal thymectomy by thoracic approach.Results:There were no significant differences in age,gender,hypertension,length of lesion,operative time,postoperative drainage volume,and pain score between the xiphoid group and the intercostal group.However,patients in the xiphoid group had more number of lymph nodes dissected and fewer days of postoperative hospital stay compared to the intercostal group.The difference was significant.Conclusion:Endoscopic subxiphoid thymus resection with sternal suspension is worthy of wider clinical recommendation,because this approach can lead to thorough resection of the lesion,safe and convenient performance,and satisfactory treatment outcomes.