Thoracic Surgery, University Hospital of Parma, via Gramsci 14, 43126 Parma, Italy.
Langenbecks Arch Surg. 2011 Feb;396(2):267-71. doi: 10.1007/s00423-010-0737-8. Epub 2010 Dec 30.
A number of surgical approaches have been reported for thymectomy, including transsternal, transcervical, a combination of complete transsternal and transcervical, and various video-assisted thoracoscopic surgery techniques. A modified video-assisted transcervical approach to thymectomy is here described.
A video-assisted total thymectomy was performed through a 30-mm cervical incision. No hyperextension of the patient's neck or sternal retractor was used. The surgical instruments utilized for the resection were the ones created for the minimally invasive video-assisted thyroidectomy.
Five patients have been operated on so far. The encapsulated gland was removed without any difficulties. No complications occurred. No pain relief was administered after the first 24 h. The patients were discharged within the first two postoperative days. An improvement in clinical symptoms was registered in all patients.
An advantage of this minimally invasive video-assisted transcervical approach to thymectomy is that the entire operation can be performed without neck hyperextension or permanent sternum elevation. Moreover, the surgical instruments created for minimally invasive video-assisted thyroidectomy enabled us to be very precise and to complete the resection without any postoperative morbidity.
胸腺切除术有多种手术入路，包括经胸骨、经颈、胸骨全切除联合经颈和各种胸腔镜辅助手术技术。本文介绍一种改良的胸腔镜辅助经颈入路胸腺切除术。
通过 30mm 的颈部切口进行胸腔镜辅助全胸腺切除术。患者颈部无需过度伸展，也无需使用胸骨牵开器。用于切除的手术器械是专为微创胸腔镜辅助甲状腺切除术而设计的。
迄今为止，已有 5 例患者接受了手术。包膜内腺体被顺利切除，无任何困难。无并发症发生。术后 24 小时内无需止痛。患者均在术后第 2 天内出院。所有患者的临床症状均有改善。
这种微创胸腔镜辅助经颈入路胸腺切除术的优点是整个手术过程无需颈部过度伸展或永久性胸骨抬高。此外，专为微创胸腔镜辅助甲状腺切除术而设计的手术器械使我们能够非常精确地完成切除，且无术后并发症。
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