Alcasid Nathan J, Vasic Ivana, Brennan Phillip G, Velotta Jeffrey B
San Francisco-East Bay, Department of Surgery, University of California, Oakland, CA, United States.
Division of Thoracic Surgery, Department of Surgery, Kaiser Permanente Northern California, Oakland, CA, United States.
Front Surg. 2024 Dec 11;11:1457029. doi: 10.3389/fsurg.2024.1457029. eCollection 2024.
Though advancements have been made in the pharmacologic treatment of myasthenia gravis (MG), surgical resection is not only an option as a last line of defense for those patients who do not respond to medical therapy but also remains vital for those with thymic epithelial tumors (TET). While prior studies have shown the potential superiority of minimally invasive approaches via robotic- and video-assisted thoracoscopic surgery (RATS/VATS) for thymectomy compared to open surgery, in the setting of malignancies, this outcome delineation is controversial. As RATS/VATS may be associated with less post-operative complications in the treatment of TET, some surgeons argue that the open approach is necessary for complete resection (R0 resection) and to prevent potential seeding of the malignancy. In this review article, we will compare the efficacy and implications of the different surgical approaches and techniques themselves in performing a thymectomy for autoimmune and oncologic pathologies.
尽管重症肌无力（MG）的药物治疗已取得进展，但手术切除不仅是那些对药物治疗无反应的患者的最后一道防线，对于患有胸腺上皮肿瘤（TET）的患者也至关重要。虽然先前的研究表明，与开放手术相比，通过机器人辅助和电视辅助胸腔镜手术（RATS/VATS）进行胸腺切除术的微创方法可能具有潜在优势，但在恶性肿瘤的情况下，这种结果描述存在争议。由于RATS/VATS在TET治疗中可能与较少的术后并发症相关，一些外科医生认为开放手术对于完整切除（R0切除）和防止恶性肿瘤的潜在播散是必要的。在这篇综述文章中，我们将比较不同手术方法和技术本身在进行自身免疫性和肿瘤性疾病胸腺切除术时的疗效和影响。
