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胸腺微创手术:全球现状:中南美洲

Thymic minimally invasive surgery: state of the art across the world: Central-South America.

作者信息

Terra Ricardo Mingarini

机构信息

Division of Thoracic Surgery, University of Sao Paulo Medical School, Sao Paulo, Brazil.

出版信息

J Vis Surg. 2017 Sep 14;3:124. doi: 10.21037/jovs.2017.07.13. eCollection 2017.

Abstract

Literature suggests that, for thymectomy in myasthenia or resection of thymic tumors, minimally invasive surgery is equivalent to open surgery with regard to long-term outcomes. However, it could bring some benefits in the immediate results as complication rate or length-of-stay. There are doubts about the worldwide adoption of the method, though. In Latin America, the implementation of video-assisted thoracic surgery (VATS) started in the 1990s, but it progressed slowly. The main barriers were associated costs and training. Thymic surgery poses a bigger challenge due to its rarity, so just a few reports mention the use of the method in the region. Nonetheless, in recent years we observe a faster dissemination of the method both in number and in complexity of the procedures performed. Confirming this fact, half of the patients registered in the Brazilian Society of Thoracic Surgery database in the last 2 years as undergoing resection of thymic tumors, underwent a minimally invasive procedure. Although promising, robotic surgery is still in its early days in Latin America.

摘要

文献表明,对于重症肌无力的胸腺切除术或胸腺肿瘤切除术,就长期疗效而言,微创手术与开放手术相当。然而,在近期结果方面,如并发症发生率或住院时间,微创手术可能会带来一些益处。不过,该方法在全球范围内的应用仍存在疑虑。在拉丁美洲,电视辅助胸腔镜手术(VATS)于20世纪90年代开始实施,但进展缓慢。主要障碍是相关成本和培训。由于胸腺手术较为罕见,其带来的挑战更大,因此该地区仅有少数报告提及该方法的使用。尽管如此,近年来我们观察到该方法在实施手术的数量和复杂性方面传播速度更快。过去两年在巴西胸外科协会数据库中登记的接受胸腺肿瘤切除术的患者中,有一半接受了微创手术,这证实了这一事实。尽管机器人手术前景广阔,但在拉丁美洲仍处于起步阶段。

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本文引用的文献

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Randomized Trial of Thymectomy in Myasthenia Gravis.重症肌无力胸腺切除术的随机试验
N Engl J Med. 2016 Aug 11;375(6):511-22. doi: 10.1056/NEJMoa1602489.
7
Robotic thymectomy for myasthenia gravis.用于重症肌无力的机器人胸腺切除术。
J Bras Pneumol. 2011 Sep-Oct;37(5):694-6. doi: 10.1590/s1806-37132011000500019.
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