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中国临床研究:2021,34(10):1370-1372
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单胸骨拉钩经剑突下单孔胸腔镜胸腺切除术77例临床应用
(南京医科大学附属脑科医院 南京市胸科医院胸外科,江苏 南京 210029)
Application of subxiphoid single-port thoracoscopic thymectomy with single sternum retractor: analysis of 77 cases
(Department of Thoracic Surgery, The Affiliated Brain Hospital of Nanjing Medical University(Nanjing Chest Hospital), Nanjing,Jiangsu 210029, China)
摘要
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投稿时间:2021-05-24   网络发布日期:2021-10-20
中文摘要: 目的 探讨经剑突下单孔胸腔镜胸腺切除术的治疗效果、安全性、可行性及优势。 方法 回顾性分析2018年9月至2020年5月完成的77例使用单胸骨拉钩经剑突下单孔胸腔镜胸腺切除术,切口位于剑突下约1 cm处,长约3 cm,术中使用单胸骨拉钩。术前临床诊断为胸腺肿瘤的患者均行全胸腺切除术,术后予祛痰、镇痛等治疗措施。 结果77例患者手术方式均为全麻下单胸骨拉钩经剑突下单孔胸腔镜全胸腺切除术,手术均顺利完成,术后病理包括恶性肿瘤65例(胸腺瘤64例,胸腺癌1例)和良性疾病12例(胸腺囊肿5例,支气管囊肿2例,胸腺增生5例),术后均顺利康复出院。术后并发症包括2例心房颤动和4例少量胸腔积液,经处理后好转;未发生膈神经麻痹、喉返神经受损、乳糜胸等严重并发症;6例术前合并重症肌无力者,术后30 d内均未发生肌无力危象;术后30 d内亦无死亡病例。 结论 经剑突下单孔入路可以实现全胸腺切除术,而且创伤较小,患者术后康复快。
Abstract:Objective To investigate the therapeutic effect, safety, feasibility and advantages of subxiphoid uni-portal thoracoscopic thymectomy. Methods A retrospective analysis was performed on 77 patients receiving subxiphoid uni-portal thoracoscopic thymectomy from September 2018 to May 2020. The incision was located about 1 cm below the xiphoid process with a length of 3 cm, and the single sternum retractor was applied during the operation. After operation,expectorant and analgesic measures were taken in all patients. Results The subxiphoid single-port thoracoscopic total thymectomy under general anesthesia were successfully completed in 77 cases. Postoperative pathology confirmed 65 cases of malignant tumors (64 cases of thymoma and 1 case of thymic cancer) and 12 cases of benign diseases (5 cases of thymic cyst, 2 cases of bronchial cyst and 5 cases of thymic hyperplasia). Postoperative complications included 2 cases of atrial fibrillation and 4 cases of small amount of pleural effusion, and the symptoms were improved after treatment. No serious complications such as phrenic nerve paralysis, laryngeal nerve damage and chylothorax occurred. No myasthenia gravis crisis occurred within 30 days after operation in 6 patients complicated with myasthenia gravis before operation. There was no death within 30 days after operation. Conclusion Transxiphoid single hole approach can achieve total thymectomy with less trauma and rapid postoperative recovery.
文章编号:     中图分类号:    文献标志码:B
基金项目:江苏省青年医学人才项目(QNRC2016124)
引用文本:
崔凯,刘政呈.单胸骨拉钩经剑突下单孔胸腔镜胸腺切除术77例临床应用[J].中国临床研究,2021,34(10):1370-1372.

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