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剑突下入路胸腔镜胸腺切除术治疗重症肌无力。

Subxiphoid thoracoscopic thymectomy for myasthenia gravis.

机构信息

Department of Respiratory and Critical Care Medicine, Xuzhou Central Hospital, Xuzhou, China.

Department of Cardiothoracic Surgery, Xuzhou Central Hospital, Xuzhou, China.

出版信息

Interact Cardiovasc Thorac Surg. 2022 Feb 21;34(3):482-484. doi: 10.1093/icvts/ivab262.

DOI:10.1093/icvts/ivab262
PMID:34626192
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8860410/
Abstract

We investigated the efficacy of subxiphoid thoracoscopic thymectomy in patients with myasthenia gravis. The data of 37 consecutive cases were reviewed. 2 cases of postoperative myasthenia gravis crisis and 4 cases of residual mediastinal fat tissue were recorded. Moreover, 29 patients presented the neurological outcomes, and complete stable remission was achieved in 5 (17.2%) cases. Subxiphoid thymectomy is technically feasible. High-quality evidence is warranted before this approach can be recommended.

摘要

我们研究了剑突下胸腔镜胸腺切除术治疗重症肌无力的疗效。回顾了 37 例连续病例的数据。记录了 2 例术后肌无力危象和 4 例纵隔脂肪残留。此外,29 例患者出现神经学结果,5 例(17.2%)达到完全稳定缓解。剑突下胸腺切除术在技术上是可行的。在推荐这种方法之前,需要有高质量的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c50c/8860410/9de19b37d54f/ivab262f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c50c/8860410/9de19b37d54f/ivab262f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c50c/8860410/9de19b37d54f/ivab262f1.jpg

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Subxiphoid thoracoscopic thymectomy for myasthenia gravis.剑突下入路胸腔镜胸腺切除术治疗重症肌无力。
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Clinical Application of Thoracoscopic Resection of Anterior Mediastinal Tumors under the Xiphoid Process.剑突下入路胸腔镜前纵隔肿瘤切除术的临床应用。
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本文引用的文献

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Evaluation of extended thymectomy approaches based on residual fat tissue.基于残余脂肪组织评估扩大胸腺切除术方法。
Interact Cardiovasc Thorac Surg. 2021 Jan 22;32(2):250-255. doi: 10.1093/icvts/ivaa242.
2
Meta-analysis of subxiphoid approach versus lateral approach for thoracoscopic Thymectomy.剑突下入路与外侧入路胸腔镜下胸腺切除术的Meta分析。
J Cardiothorac Surg. 2020 May 12;15(1):89. doi: 10.1186/s13019-020-01135-w.
3
Perioperative outcomes and mid-term effects in performing video-assisted thoracoscopic extended thymectomy for myasthenia gravis: subxiphoid versus right thoracic approaches.
重症肌无力患者行电视胸腔镜扩大胸腺切除术的围手术期结局及中期效果:剑突下与右胸入路对比
J Thorac Dis. 2020 Apr;12(4):1529-1539. doi: 10.21037/jtd.2020.03.43.
4
Review Analysis on Thymectomy vs Conservative Medical Management in Myasthenia Gravis.重症肌无力胸腺切除术与保守药物治疗的综述分析
Cureus. 2020 Mar 26;12(3):e7425. doi: 10.7759/cureus.7425.
5
Unraveling the role of ectopic thymic tissue in patients undergoing thymectomy for myasthenia gravis.揭示异位胸腺组织在重症肌无力患者胸腺切除术中的作用。
J Thorac Dis. 2019 Sep;11(9):4039-4048. doi: 10.21037/jtd.2019.08.109.
6
Non-intubated subxiphoid uniportal video-assisted thoracoscopic thymectomy.非气管插管剑突下单孔电视辅助胸腔镜胸腺切除术
Interact Cardiovasc Thorac Surg. 2019 Nov 1;29(5):742-745. doi: 10.1093/icvts/ivz181.
7
Long-term effect of thymectomy plus prednisone versus prednisone alone in patients with non-thymomatous myasthenia gravis: 2-year extension of the MGTX randomised trial.非胸腺瘤性重症肌无力患者胸腺切除术联合泼尼松与单纯泼尼松治疗的长期疗效:MGX 随机试验的 2 年延伸。
Lancet Neurol. 2019 Mar;18(3):259-268. doi: 10.1016/S1474-4422(18)30392-2. Epub 2019 Jan 25.
8
Comparison of Conservative Treatment and Thymectomy on Myasthenia Gravis Outcome.重症肌无力保守治疗与胸腺切除术疗效比较
Ann Thorac Surg. 2016 Dec;102(6):1805-1813. doi: 10.1016/j.athoracsur.2016.08.052. Epub 2016 Oct 27.
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Eur J Cardiothorac Surg. 2010 May;37(5):1137-43. doi: 10.1016/j.ejcts.2009.11.029. Epub 2010 Feb 8.
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