经剑突下人工气胸辅助胸腔镜手术治疗胸腺疾病  

Artificial pneumothorax assisted subxiphoid video assisted thoracic surgery for disease of thymus gland

作　　者：庞文广[1] 黄凤柳[2] 叶敏[1] 庞景灼[1] 

机构地区：[1]江门市中心医院胸外科,529030 [2]江门市中心医院呼吸内科,529030

出　　处：《国际医药卫生导报》2017年第9期1346-1349,共4页International Medicine and Health Guidance News

摘　　要：目的探讨经剑突下人工气胸辅助胸腔镜手术治疗胸腺疾病的安全性、疗效及并发症情况。方法回顾分析本院对12例胸腺疾病予经剑突下人工气胸辅助胸腔镜手术进行治疗，观察手术效果及并发症的出现情况，并随访最少半年，观察术后的短期疗效。结果手术时间为50～120 min，平均（82.0±15.2）min；出血量10～100 ml，平均为（38.3±13.2）ml；术后住院时间为4～6 d，平均（4.2±0.9）d；所有手术均获得成功，无中转开胸，无围手术期死亡。术后无损伤膈神经、胸腔积液、肺不张、支气管胸膜瘘等并发症，6例术前合并重症肌无力患者，术后未见出现肌无力危象，肌无力症状均有改善，3例完全缓解，3例部分缓解解。随访半年以上，无肿瘤复发转移。结论气腹机辅助经剑突下手术治疗胸腺疾病操作简单可行,并发症少，伤口隐蔽美观，术后效果理想，前景良好，可在临床上推广应用。Objective To explore the safety, effect and complication of artificial pneumothorax assisted subxiphoid video assisted thoracic surgery （ VATS ） for disease of thymus gland. Methods The clinical data of 12 cases treated with artificial pneumothorax assisted subxiphoid video assisted thoracic surgery at our hospital were retrospective analyzed. The intraoperative and postoperative effects and complications were observed. All patients were followed up for at least half year. Results The operation time was 50-120 min [（82.0±15.2） mini. The bleeding volume during operation was 10-100 ml [（38.3±13.2） ml]. The hospitalization time was 4-6 d [（4.2±0.9） d]. No conversion to open surgery was required and no perioperative death occurred in this study. No complication of phrenic nerve damage, pleural effusion, atelectasis, and bronchopleural fistula occurred in this study. 6 cases with myasthenia gravis did not occurred myasthenia crisis after operation and the symptoms of myasthenia gravis were alleviated （3 cases were complete remission and 3 cases partial remission）. They followed up more than half years, no tumor recurrence and metastasis were found. Conclusions Artificial pneumothorax assisted subxiphoid Video assisted thoracic surgery for disease of thymus gland is significantly effective and easy to perform and has few complications and incision with good cosmesis, so it is worth being clinically generalized.

关 键 词：人工气胸 剑突下 胸腔镜 胸腺 微创 

分 类 号：R655.7[医药卫生—外科学]