Bramis J, Diamantis T, Tsigris C, Pikoulis E, Papaconstantinou I, Nikolaou A, Leonardou P, Bastounis E
First Surgical Department, Athens University, Medical School, Laikon Hospital, Athens, Greece.
Surg Endosc. 2004 Oct;18(10):1535-8. doi: 10.1007/s00464-003-9203-9. Epub 2004 Aug 26.
The optimal surgical approach for complete removal of the thymus gland has long been debated. In this report, the excision of the entire gland through a transcervical incision using video-assisted techniques is described.
Ten patients, including one with thymoma and myasthenia gravis, underwent surgery via the transcervical approach. After standard dissection up to the level of the innominate vein and ligation of the thymic vessels, a laparoscope was inserted into the mediastinum. In the patient with thymoma, the operation was completed by a small incision in the third intercostal space.
No perioperative mortality or long-term morbitity was observed. The mean hospital stay was 69.6 h. After a mean follow-up period of 63.8 months, eight patients displayed complete remission, whereas one continued to receive minimal medication. The patient with thymoma showed considerable improvement, but remained on same medical regimen No complications were seen throughout the study.
Video-assisted thymectomy improves effectiveness of the transcervical approach for thymectomy with a minimum of trauma and excellent results.
长期以来，关于完全切除胸腺的最佳手术方法一直存在争议。在本报告中，描述了使用视频辅助技术通过颈部切口切除整个胸腺的方法。
10例患者接受了经颈部入路手术，其中1例患有胸腺瘤合并重症肌无力。在标准解剖至无名静脉水平并结扎胸腺血管后，将腹腔镜插入纵隔。对于胸腺瘤患者，通过第三肋间的小切口完成手术。
未观察到围手术期死亡或长期发病情况。平均住院时间为69.6小时。平均随访63.8个月后，8例患者完全缓解，1例仍需少量药物治疗。胸腺瘤患者有显著改善，但仍维持相同的治疗方案。整个研究过程中未出现并发症。
视频辅助胸腺切除术提高了经颈部胸腺切除术的有效性，创伤最小且效果极佳。
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