Tang Yong, Ou Zhu-An, Liao Ming, Xuan Yiwen, Su Kai, Xu En-Wu, Xiao Haiping, Peng Xiufan, Zhang Zhuohua, Liu Yan, Qiao Gui-Bin
Department of Thoracic Surgery, Liuhuaqiao Hospital, Guangzhou 510515, China.
J Thorac Dis. 2016 Mar;8(3):499-504. doi: 10.21037/jtd.2016.02.77.
Extended thymectomy is indicated for patients with myasthenia gravis (MG) when drug-resistance or dependence is seen. We have employed a technique for subcostal thoracoscopic extended thymectomy (STET) on patients with MG.
Clinical data of 15 eligible patients who underwent STET in our department from February 2015 to November 2015 by the same surgical team were retrospectively analyzed. The operation time, blood loss, duration of postoperative hospital stay, thoracic drainage periods were concerned.
All the surgeries were finished successfully without conversion to sternotomy. Mean operation time was 157.53±40.31 min (range, 73-275 min). Mean blood loss was 56.33±7.07 mL (range, 10-200 mL). Mean pleural drainage volume in the first 24 hours was 72.67±17.68 mL (range, 0-250 mL). Mean postoperative thoracic drainage periods were 1.20±0.71 days (range, 0-3 days). Mean duration of postoperative hospital stay was 6.13±0.71 days (range, 3-22 days).
This procedure showed satisfactory results for patients with MG. Moreover, the STET approach is more easily for surgeons to fully reveal the bilateral phrenic nerve and the upper thymic poles. We believe that STET is a satisfactory procedure for performing extended thymectomy in well selected patients.
对于出现耐药或依赖的重症肌无力（MG）患者，建议行扩大胸腺切除术。我们已采用一种技术对MG患者进行肋下胸腔镜扩大胸腺切除术（STET）。
回顾性分析2015年2月至2015年11月在我科由同一手术团队进行STET的15例符合条件患者的临床资料。关注手术时间、出血量、术后住院时间、胸腔引流时间。
所有手术均成功完成，未中转开胸。平均手术时间为157.53±40.31分钟（范围73 - 275分钟）。平均出血量为56.33±7.07毫升（范围10 - 200毫升）。术后第1个24小时平均胸腔引流量为72.67±17.68毫升（范围0 - 250毫升）。术后平均胸腔引流时间为1.20±0.71天（范围0 - 3天）。术后平均住院时间为6.13±0.71天（范围3 - 22天）。
该手术对MG患者显示出满意的效果。此外，STET方法对外科医生来说更容易充分显露双侧膈神经和胸腺上极。我们认为STET是在精心挑选的患者中进行扩大胸腺切除术的一种令人满意的手术方法。
