Clinical comparative analysis of thymectomy between subxiphoid and subcostal arch thoracoscopic resection and open resection for the treatment of thymoma with myasthenia gravis
10.3760/cma.j.issn.1001-4497.2019.04.011
- VernacularTitle:胸腔镜剑突肋缘下与纵劈胸骨手术治疗重症肌无力临床疗效对比
- Author:
Xunliang YIN
1
;
Zhengwei ZHAO
;
Shaoyi CHENG
;
Yan WANG
;
Zheng FENG
;
Yongan ZHOU
Author Information
1. 空军军医大学唐都医院胸外科
- Keywords:
Invasive thymoma;
Video-assisted thoracic surgery;
Subxiphoid approach;
Median sternotomy;
Myasthenia gravis
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(4):239-242
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare and analyze clinical effects of extended thymectomy for the treatment of thymoma with myasthenia gravis(MG) between subxiphoid and subcostal arch thoracoscopic resection(SR) and the median sternotomy(MS) with a propensity-matched analysis.Methods We retrospectively analyzed 528 patients presented with MG and admitted in Tangdu Hospital of Air Force Military Medical University from December 2011 to December 2016,among whom 402 underwent subxiphoid and subcostal arch thoracoscopic extended thymectomy(SR group) and 126 median sternotomy(MS group).Another 126 patients were produced by a propensity-matched analysis in these 402 patients,to match with MS group.Perioperative outcomes were compared between SR group and MS group.Results All operations were accomplished successfully,without conversion to thoracotomy in SR group.Most postoperative outcomes were equal in remission of MG and postoperative complication between the two groups(P ＞ 0.05).There were statistical differences between MS group and SR group in operation time [(106.3 ±32.7)min vs.(533.2 ±37.3) min],intraoperative blood loss[(138.2 ±26.7)ml vs.(38.2 ± 10.3) ml],chest drainage duration[(3.3 ± 1.6) days vs.0 day],hospital length of stay [(5.0 ± 2.5) days vs.(2.5 ± 1.8) days],patients'satisfaction level(6.1 ±2.3 vs.8.9 ± 1.2),the incidence of postoperative wound infections(4.8％ vs.0.8％),the incidence of myasthenic crisis(7.1％ vs.1.6％)and pain scores,all P ＜0.05.Conclusion Subxiphoid and subcostal arch thoracoscopic extended thymectomy is a safe and feasible minimally invasive procedure for tmanagement of MG with thymoma.
