Department of Surgery, Jikei University School of Medicine, Minatoku, Tokyo, Japan.
Eur J Cardiothorac Surg. 2010 Apr;37(4):824-6. doi: 10.1016/j.ejcts.2009.10.003. Epub 2009 Nov 12.
The purpose of this study was to determine the feasibility of thoracoscopic thymectomy for the treatment of Masaoka stage I and II thymoma.
We evaluated the short-term outcomes of 40 patients undergoing surgery for Masaoka stage I and II thymomas without myasthenia gravis between July 2000 and July 2008. Of these, 22 patients underwent complete thymoma resection using unilateral thoracoscopic subtotal thymectomy (UTST group), and 18 patients underwent trans-sternal thymectomy (TST group).
Intra-operative blood loss amounts did not differ significantly between the UTST and TST groups (100.6 ml and 208.1 ml, respectively, p=0.0513). The duration of the postoperative hospital stay was significantly shortened in the UTST group (4.6 days vs 11.2 days, p<0.0001). No patient in the UTST group underwent conversion to open surgery. No severe surgical complications, such as bleeding due to injury to the left brachiocephalic vein, and no postoperative complications, were detected in this series.
These preliminary results suggest that thoracoscopic thymectomy for Masaoka stage I and II thymoma is technically feasible and safe, and it is less invasive for the patient. Nevertheless, this procedure requires further investigation in a large series with a longer follow-up.
本研究旨在探讨胸腔镜胸腺切除术治疗 Masaoka Ⅰ期和Ⅱ期胸腺瘤的可行性。
我们评估了 2000 年 7 月至 2008 年 7 月期间 40 例无重症肌无力的 Masaoka Ⅰ期和Ⅱ期胸腺瘤患者的短期手术结果。其中 22 例患者接受了单侧胸腔镜下胸腺次全切除术（UTST 组），18 例患者接受了胸骨正中切开术（TST 组）。
UTST 组和 TST 组的术中出血量差异无统计学意义（分别为 100.6ml 和 208.1ml，p=0.0513）。UTST 组的术后住院时间明显缩短（4.6 天比 11.2 天，p<0.0001）。UTST 组无患者中转开胸手术。该系列研究中未发现严重手术并发症，如因左头臂静脉损伤导致出血，也无术后并发症。
这些初步结果表明，胸腔镜胸腺切除术治疗 Masaoka Ⅰ期和Ⅱ期胸腺瘤在技术上是可行和安全的，对患者的创伤较小。然而，这一手术需要在更大的系列和更长的随访中进一步研究。
