电视胸腔镜胸腺切除9例报告

Video-assisted thoracoscopic thymectomy (a report of 9 cases)

目的 探讨电视胸腔镜下行胸腺切除的可行性及合并重症肌无力患者的远期疗效。 方法 1996年 7月至 2 0 0 1年 4月 ,选择 9例胸腺相关疾病患者 ,应用电视辅助胸腔镜 (VATS)行胸腺切除 ,术后门诊或电话随访。 结果 胸腺囊肿 2例 ,胸腺瘤 1例 ,恶性胸腺瘤 1例 ,胸腺癌 1例 ,重症肌无力4例。重症肌无力据改良Osserman分型Ⅰ型 3例 ,Ⅱb型 1例 ,合并胸腺瘤 2例 ,胸腺增生 2例 ,手术总有效率 3/ 4。手术中转开胸 1例 ,手术后随访复发 1例 ,经胸骨正中切口行胸腺扩大切除术。 结论 VATS治疗部分胸腺疾病可行 ,VATS治疗重症肌无力疗效与常规手术相当。

Objective To study the feasibility of Video-assisted thoracoscopic thymectomy and the long term result of thoracoscopic thymectomy for myasthenia gravis. Methods 9 cases of thymus related disease were selected to undergo thymectomy though thoracoscopic approach from August 1996 to April 2001.Patients were followed up through outpatient service and telephone consultation. Results Of the 9 cases 2 cases were diagnosed as thymus cysts,1 cases thymoma,1 case malignant thymoma,1cases thymus carcinoma and 4 cases myasthenia gravis.Of the 4 cases of myasthenia gravis,3 cases were typeⅠ and 1 case was typeⅡb according to the modified Osserman classification.After thoracoscopic thymectomy 75% of patients had long-term good responses to surgery.The operation of one case of malignant thymoma was converted to lateral thoracotomy.One case of malignant thymoma with myasthenia gravis relapsed and reoperated through open thoracotomy . Conclusions video-assisted thoracoscopy can be usd to treat seleted thymic diseases .The results of video-assisted thoracoscopic thymectomy for mysthenia gravis is almost comparable with traditional open thoracotomy