Comparison of perioperative outcomes of robotic trans-subxiphoid and video-assisted thoracoscopic extended thymectomy in the treatment of myasthenia gravis complicated with thymoma
- VernacularTitle:经剑突下达芬奇机器人手术与传统胸腔镜手术治疗重症肌无力合并胸腺瘤的对比研究
- Author:
Wei WANG
1
;
Chuan LI
2
;
Lin LIN
1
;
E ZHENG
1
;
Yong YUAN
2
;
Yun WANG
2
;
Jiandong MEI
2
;
Mei YANG
1
Author Information
1. West China School of Nursing, Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China
- Publication Type:Journal Article
- Keywords:
Da Vinci surgical system;
thoracoscope;
myasthenia gravis;
thymoma;
surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(11):1287-1291
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the perioperative outcomes of subxiphoid robot-assisted extended thymectomy (SRAET) and video-assisted thoracoscopic extended thymectomy (VATET) for myasthenia gravis complicated with thymoma. Methods Retrospective analysis of 61 patients with myasthenia gravis combined with thymoma who were admitted to the Department of Thoracic Surgery, West China Hospital, Sichuan University from January 2017 to June 2019 was performed. All patients underwent extended thymectomy, and the patients were divided into a SRAET group and a VATET group. There were 26 patients in the SRAET group, including 11 males and 15 females, with an average age of 42.20±13.20 years. There were 35 patients in the VATET group, including 14 males and 21 females, with an average age of 45.00±13.00 years. The perioperative outcomes of the two groups including gender, age, operation time, intraoperative blood loss, conversion rate, postoperative drainage, tube removal time, drainage volume, visual analogue scale, hospital stay and postoperative complications were compared. Results There was no conversion to thoracotomy, death or myasthenia crisis in both groups. The operation time (111.42±28.60 min vs. 103.71±26.20 min, P=0.845), intraoperative blood loss (32.31±23.84 mL vs. 63.57±132.22 mL, P=0.239), visual analogue scale at postoperative 24 h (2.46±0.76 vs. 2.40±0.74, P=0.751) and postoperative 48 h (2.12±0.77 vs. 2.26±0.56, P=0.407), complication rate (3.8%vs. 2.9%, P=0.675), drainage volume (206.85±130.09 mL vs. 276.86±173.46 mL, P=0.089) and hospital stay (5.81±2.52 d vs. 5.29±2.17 d, P=0.642) were not significantly different between the two groups. The visual analogue scale of the SRAET group at postoperative 72 h (1.12±0.65 vs. 1.86±0.91, P=0.001) was significantly lower than that of the VATET group. Conclusion SRAET is a safe and feasible method with less postoperative short-term pain, which is an alternative surgical treatment for myasthenia gravis complicated with thymoma.
