Cooper Medical School of Rowan University, Camden, New Jersey, USA
Endocrine Surgery, Cooper University Health Care, Camden, New Jersey, USA.
BMJ Case Rep. 2022 Apr 22;15(4):e249292. doi: 10.1136/bcr-2022-249292.
Myasthenia gravis (MG) is the most common autoimmune disorder affecting the neuromuscular junction in the USA. It is not uncommon for these patients to have concomitant autoimmune diseases including autoimmune thyroid disease. We describe here our method of performing a reproducible robotically assisted one-stage thymectomy and thyroidectomy. An African-American woman presented to our institution with a medical history of hypertension, morbid obesity, type 2 diabetes mellitus, symptomatic MG and symptomatic non-toxic substernal multinodular goitre. A one-stage minimally invasive right-sided robotic radical thymectomy and a transcervical total thyroidectomy with excision of the substernal goitre was successfully performed. The treatment of thyroid and thymus pathologies varies drastically from medical observation to surgery. This combined approach surgery clearly benefits the patient by offering similar operative time, fewer operative and postoperative recovery experiences, decreased anaesthesia risks associated with MG patients through fewer intubations, and a faster return to baseline function.
重症肌无力(MG)是美国最常见的影响神经肌肉接头的自身免疫性疾病。这些患者同时患有自身免疫性疾病并不罕见,包括自身免疫性甲状腺疾病。我们在此描述了一种可重复的机器人辅助一期胸腺切除术和甲状腺切除术的方法。一名非裔美国妇女因高血压、病态肥胖、2 型糖尿病、有症状的 MG 和有症状的胸骨后多结节性甲状腺肿而到我院就诊。成功地进行了一期微创右侧机器人根治性胸腺切除术和经颈全甲状腺切除术,切除胸骨后甲状腺肿。甲状腺和胸腺病变的治疗方法从医学观察到手术有很大的不同。这种联合治疗方法通过减少与 MG 患者相关的麻醉风险(通过减少插管次数)、手术和术后恢复体验更少、更快地恢复到基线功能,为患者带来了明显的益处。