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[胸腺瘤患者的再次手术]

[Reoperation in patients with thymoma].

作者信息

Kametani Y, Yoshitake T, Takahama T, Kanai F, Onishi K, Suzuki T, Yamaya I, Hirose K, Nagayama H, Tada M

机构信息

First Department of Surgery, Saitama Medical School, Kawagoe, Japan.

出版信息

Kyobu Geka. 1993 Jan;46(1):74-8.

PMID:8418364
Abstract

For past seven years, reoperations were carried out for six patients with thymoma and myasthenia gravis (MG). Of six patients, five patients were suspected recurrent thymoma and remaining one patient was diagnosed as the residual thymus after thymothymectomy or thymomectomy. Myasthenia gravis has been progressing in five patients after initial operation except for one patient. Two cases of pleural dissemination tumors, one case of local recurrent thymoma and one case of the residual thymus were confirmed by surgery, remaining two patients had no recurrent tumor. As surgical procedure, median sternotomy using for reoperation has a great surgical risk, because left brachiocephalic vein closely adhered to the sternum is apt to be injured. Clinical symptoms of MG were improved in all the patients after reoperation regardless of recurrent tumor.

摘要

在过去七年中,对6例胸腺瘤合并重症肌无力(MG)患者进行了再次手术。6例患者中,5例怀疑为复发性胸腺瘤,其余1例在胸腺切除术或胸腺瘤切除术后被诊断为残留胸腺。除1例患者外,其余5例患者在初次手术后重症肌无力病情一直在进展。通过手术证实了2例胸膜播散性肿瘤、1例局部复发性胸腺瘤和1例残留胸腺,其余2例患者无肿瘤复发。作为再次手术的手术方式,使用正中胸骨切开术具有很大的手术风险,因为紧密附着于胸骨的左头臂静脉容易受损。无论肿瘤是否复发,所有患者再次手术后重症肌无力的临床症状均得到改善。

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