Tomulescu V, Ion V, Ciurea S, Tulbure D, Radan A, Tomescu D, Hrehoret D, Georgescu S, Popescu I
Clinica de Chirurgie Generală II, Spitalul Clinic Fundeni, Sos. Fundeni 258, sector 2, Bucureşti.
Chirurgia (Bucur). 2000 Mar-Apr;95(2):215-20.
Video-assisted thoracoscopic surgery (VATS) provides a new approach to thymectomy. From April 1999 to December 1999, we performed a total of 10 video-assisted thoracoscopic thymectomies for myasthenia gravis (MG). There were one male and nine female patients with ages ranging from 8 to 59 years. Thymoma was present in one of the ten patients. We considered that complete thymectomy was accomplished in all cases by examination of the thymic bed and of the resected specimen. There was no mortality or intraoperative complications. The median postoperative hospital stay was 4 days. Clinical improvement was observed in all patients after this short follow-up. Compared with a similar historical group of patients with MG who underwent transsternal thymectomy, the VATS group was associated with significantly less analgesic requirement and shortened hospital stay. We conclude that VAT thymectomy is technically feasible and is associated with a favorable postoperative course compared with the transsternal approach. We believe that complete thymectomy can be achieved by this approach. Further investigation with long-term follow-up is needed to further clarify the role of VAT thymectomy in thoracic surgery.
电视辅助胸腔镜手术（VATS）为胸腺切除术提供了一种新方法。1999年4月至1999年12月，我们共为重症肌无力（MG）患者实施了10例电视辅助胸腔镜胸腺切除术。患者中男性1例，女性9例，年龄在8至59岁之间。10例患者中有1例存在胸腺瘤。我们认为通过检查胸腺床和切除标本，所有病例均完成了完整的胸腺切除术。无死亡病例或术中并发症。术后中位住院时间为4天。经过这一短期随访，所有患者均有临床改善。与一组接受经胸骨胸腺切除术的MG历史对照患者相比，VATS组的镇痛需求明显减少，住院时间缩短。我们得出结论，与经胸骨入路相比，VATS胸腺切除术在技术上是可行的，且术后病程良好。我们相信通过这种方法可以实现完整的胸腺切除术。需要进行长期随访的进一步研究，以进一步阐明VATS胸腺切除术在胸外科手术中的作用。
