双侧胸腔镜手术治疗侵袭性胸腺瘤并发重症肌无力1例报告及文献复习

doi:10.13481/j.1671-587x.20180135

吉林大学学报(医学版) ›› 2018, Vol. 44 ›› Issue (01): 179-181.doi: 10.13481/j.1671-587x.20180135

双侧胸腔镜手术治疗侵袭性胸腺瘤并发重症肌无力1例报告及文献复习

许哲男, 商圣涛, 陆毓峰, 张吉, 陈冲, 陈悦, 赵维

吉林大学中日联谊医院胸外科, 吉林长春 130033

收稿日期:2017-06-08 出版日期:2018-01-28 发布日期:2018-01-24
通讯作者: 赵维,副教授,硕士研究生导师(Tel:0431-84997545,E-mail:ruweizhao08@163.com) E-mail:ruweizhao08@163.com
作者简介:许哲男(1985-),男,吉林省龙井市人,主治医师,在读医学博士,主要从事胸部肿瘤的外科治疗和综合治疗方面的研究。
基金资助:
吉林省科技厅基础研究项目资助课题（20160101114JC）

Bilateral thoracoscopic surgery for invasive thymoma complicated with myasthenia gravis: A case report and literature review

XU Zhenan, SHANG Shengtao, LU Yufeng, ZHANG Ji, CHEN Chong, CHEN Yue, ZHAO Wei

Department of Thoracic Surgery, China-Japan Union Hospital, Jilin University, Changchun 130033, China

Received:2017-06-08 Online:2018-01-28 Published:2018-01-24

摘要/Abstract

摘要： 目的：观察侵袭性胸腺瘤并发重症肌无力的双侧胸腔镜手术治疗效果，探讨其手术操作的可行性。方法：采用双侧胸腔镜下胸腺扩大切除术治疗1例侵袭性胸腺瘤并发重症肌无力患者，双侧入路完整切除胸腺瘤及前纵隔脂肪组织，观察其疗效。结果：双侧胸腔镜手术切除侵袭性胸腺瘤达到了根治效果，术后患者肌无力症状明显缓解，同时避免了开放手术创伤大、并发症多，以及单侧胸腔镜下不能清扫对侧脂肪及遗留迷走胸腺的弊端。结论：双侧胸腔镜下微创胸腺扩大切除术治疗侵袭性胸腺瘤并发重症肌无力同样能达到根治的效果，证实了手术操作的可行性。

关键词: 电视胸腔镜手术, 胸腺扩大切除术, 重症肌无力, 侵袭性胸腺瘤

Abstract: Objective: To observe the effect of bilateral thoracoscopic surgery for invasive thymoma complicated with myasthenia gravis, and to explore feasibility of surgical procedure. Methods: Bilateral thoracoscopic extended thymectomy was performed in one patient with invasive thymoma complicated with myasthenia gravis,with complete resection of thymus and anterior mediastinal adipose tissue through bilateral approach,and the curative effect was observed. Results: Bilateral thoracoscopic thymectomy for invasive thymoma had radical effects with rapid recovery after surgery,avoiding large surgical trauma and more complications in open surgery and flawed in removing contralateral fat and ectopic thymus with unilateral thoracoscope. Conclusion: Bilateral thoracoscopic extended thymectomy has radical effects for invasive thymoma complicated with myasthenia gravis,confirming its feasible surgical procedure.

Key words: invasive thymoma, myasthenia gravis, video-assisted thoracoscopic surgery, extended thymectomy

中图分类号:

R746.1

许哲男, 商圣涛, 陆毓峰, 张吉, 陈冲, 陈悦, 赵维. 双侧胸腔镜手术治疗侵袭性胸腺瘤并发重症肌无力1例报告及文献复习[J]. 吉林大学学报(医学版), 2018, 44(01): 179-181.

XU Zhenan, SHANG Shengtao, LU Yufeng, ZHANG Ji, CHEN Chong, CHEN Yue, ZHAO Wei. Bilateral thoracoscopic surgery for invasive thymoma complicated with myasthenia gravis: A case report and literature review[J]. Journal of Jilin University Medicine Edition, 2018, 44(01): 179-181.

参考文献

[1] Duwe BV,Sterman DH,Musani AI.Tumors of the mediastinum[J].Chest,2005,128(4):2893-2909.
[2] Ichimura H,Usui S,Okazaki H, et al.Excision after chemoradiotherapy of invasive thymoma extending into the right atrium:report of a case[J].Surg Today,2006,36(6):534-537.
[3] Suster S,Moran CA.Thymoma classification:current status and future trends[J].Am J Clin Pathol,2006,125(4):542-554.
[4] LePéchoux C,Mahé M,Bretel JJ,et al.Thymic tumors[J].Cancer Radiother,2005,9(6/7):351-357.
[5] 邹强,赵夏,黄云,等.放化疗联合胸腺瘤切除术治疗重症肌无力合并胸腺瘤的临床效果评价[J].医学综述,2016,22(24):4989-4992.
[6] 张文军.胸腔镜与胸骨正中劈开胸腺扩大切除治疗重症肌无力并胸腺瘤的比较[D].合肥:安徽医科大学,2016.
[7] 吕传真.重症肌无力的临床特征和诊断[J].中国实用内科杂志,1994,6(14):325-326.
[8] Sun XG,Wang YL,Liu YH,et al.Myasthenia gravis appearing after thymectomy[J].J Clin Neurosci, 2011,18(1):57-60.
[9] 钱昆杰,孙清超,张海平,等.胸腺瘤切除术后发生重症肌无力的危险因素分析[J].中国胸心血管外科临床杂志,2017,23(1):20-24.
[10] Pennathur A,Qureshi I,Schuchert MJ,et al.Comparison of surgical techniques for early-stagethymoma:feasibility of minimally invasive thymectomy and comparison with open resection[J].J Thorac Cardiovasc Surg,2011,141(3):694-701.
[11] Gu ZT,Mao T,Chen WH,et al.Comparison of video-assisted thoracoscopic surgery and median sternotomy approaches for thymic tumor resections at a single institution[J].Surg Laparosc Endosc Percutan Tech,2015,25(1):47-51.
[12] Odaka M,Akiba T,Yabe M,et al.Unilateral thoracoscopic subtotal thymectomy for the treatment of stage Ⅰ and Ⅱ thymoma[J].Eur J Cardiothorac Surg,2010,37(4):824-826.
[13] Ng CS,Wan IY,Yim AP.Video-assisted thoracic surgery thymectomy:the better approach[J].Ann Thorac Surg,2010,89(6):S2135-S2141.
[14] Jurado J,Javidfar J,Newmark A,et al.Minimally invasive thymectomy and open thymectomy:outcome analysis of 263 patients[J].Ann Thorac Surg,2012,94(3):974-981.
[15] Ye B,Tantai JC,Ge XX,et al.Surgical techniques for early-stage thymoma:video-assisted thoracoscopic thymectomy versus transsternal thymectomy[J].J Thorac Cardiovasc Surg,2014,147(5):1599-1603.

双侧胸腔镜手术治疗侵袭性胸腺瘤并发重症肌无力1例报告及文献复习

Bilateral thoracoscopic surgery for invasive thymoma complicated with myasthenia gravis: A case report and literature review

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