CAJ | 학술논문

回顾比较我院2008年6月至2012年12月行胸腔镜(24例)和经胸正中切口(19例)行胸腺瘤切除术治疗患者的临床资料.腔镜组的手术时间、失血量、术后住院时间、胸液引流时间及引流量等方面明显优于开胸组,差异有统计学意义(均P ＜0.05).腔镜组总并发症发生率4％(1/24),少于开胸组(4/19),但差异无统计学意义(P＞0.05).开胸组中合并重症肌无力者总有效缓解比例为7/9,与开胸组(6/8)相当(P＞0.05);腔镜组随访23例,无复发或转移,生存率100％(23/23),开胸组随访17例,复发或转移1例、死亡1例,生存比例16/17 (P ＞0.05).提示胸腔镜行胸腺瘤切除术创伤小、并发症少、恢复快,具有和开胸手术相似的近期疗效,是安全、可行、临床效果好的微创术式.
회고비교아원2008년6월지2012년12월행흉강경(24례)화경흉정중절구(19례)행흉선류절제술치료환자적림상자료.강경조적수술시간、실혈량、술후주원시간、흉액인류시간급인류량등방면명현우우개흉조,차이유통계학의의(균P ＜0.05).강경조총병발증발생솔4％(1/24),소우개흉조(4/19),단차이무통계학의의(P＞0.05).개흉조중합병중증기무력자총유효완해비례위7/9,여개흉조(6/8)상당(P＞0.05);강경조수방23례,무복발혹전이,생존솔100％(23/23),개흉조수방17례,복발혹전이1례、사망1례,생존비례16/17 (P ＞0.05).제시흉강경행흉선류절제술창상소、병발증소、회복쾌,구유화개흉수술상사적근기료효,시안전、가행、림상효과호적미창술식.
From June 2008 to December 2012,video-assisted thoracoscopic surgery (VATS group) was performed for 24 cases of thymoma.Their operative procedures,postoperative complications,remission of myasthenia gravis (MG),perioperative mortality and oncological outcomes were compared with 19 cases of trans-sternal open thymectomy (OT group).Compared with OT group,VATS group had significantly shorter operation duration,less blood loss,shorter postoperative hospital stay,shorter chest tube duration and less chest drainage amount (P ＜ 0.05).The total rate of postoperative complications of VATS group was 4％ (1/24) and it was less than OT group (4/19) without significant difference (P ＞0.05).The effective remission rate of thymomatous MG was 7/9 in VATS group and it was similar to that in OT group (6/8,P ＞ 0.05).VATS group had a recurrent or metastatic rate of 0％ (0/23) and it was better than OT group with 1/17.And there was no significant inter-group difference (P ＞ 0.05).The total survival rate of VATS group was 100％ and it was similar to that of OT group (16/17,P ＞ 0.05).Thoracoscopic thymectomy is safe,feasible,efficacious and mini-invasive for thymoma.With fewer complications and a quicker recovery,it has similar short-term outcomes to conventional open thymectomy.