首页 中华胸心血管外科杂志 2018年34卷4期 双拉钩胸骨悬吊法胸腔镜剑突下全胸腺切除术
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ENGLISH ABSTRACT
双拉钩胸骨悬吊法胸腔镜剑突下全胸腺切除术
范江 
李好
李玉萍
徐欣楠
段亮
杨倍
王海峰
何文新
姜格宁
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1001-4497.2018.04.007
VATS thymectomy with suspension of sternum by double hook through xiphoid
Fan Jiang
Li Hao
Li Yuping
Xu Xinnan
Duan Liang
Yang Bei
Wang Haifeng
He Wenxin
Jiang Gening
Authors Info & Affiliations
Fan Jiang
Department of Cardiothoracic Surgery, Affiliated of Tongji University, Shanghai Lung Hospital, Shanghai 200433, China
Li Hao
Li Yuping
Xu Xinnan
Duan Liang
Yang Bei
Wang Haifeng
He Wenxin
Jiang Gening
·
DOI： 10.3760/cma.j.issn.1001-4497.2018.04.007
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摘要
目的评价自制悬吊双拉钩系统用于剑突下胸腔镜全胸腺切除术的效果。
方法选择2016年11月至12月17例住院治疗的术前诊断为胸腺瘤的患者，男7例，女10例；年龄(57±10)岁。行悬吊双拉钩胸骨胸腔镜剑突下全胸腺瘤切除术。
结果17例患者均手术顺利，术后未见明确的拉钩相关并发症。手术便捷，完全切除胸腺。
结论双拉钩胸骨悬吊法剑突下切除全胸腺便捷安全，值得推广。
胸腺;剑突下;胸腔镜;胸外科手术;拉钩
ABSTRACT
ObjectiveEvaluation of self-control suspension under the double hook system used to xiphoid thoracoscope fully the effect of thymectomy.
MethodsThere were 17 cases of thymic adenoma diagnosed before surgery in November to December 2016, including 7 males and 10 females, aged(57±10). The total thymomectomy was performed with a double hook method with a double hook procedure.
ResultsAll the 17 patients had smooth operation, and no clear hook related complications were observed after the operation. The operation was convenient and the thymus was completely removed.
ConclusionIt is worth populating that the double pull hook method is convenient and safe to remove the whole thymus gland.
Thymus;Xiphoid;Thoracoscope;Thoracic surgical procedures;Retractor
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引用本文
范江,李好,李玉萍,等. 双拉钩胸骨悬吊法胸腔镜剑突下全胸腺切除术[J]. 中华胸心血管外科杂志,2018,34(4)：221-225.
DOI:10.3760/cma.j.issn.1001-4497.2018.04.007PERMISSIONS
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胸腺瘤常见，目前主要的治疗方法是手术。由于存在异位胸腺，术中要求切除全胸腺。传统全胸腺切除术需采用正中劈开胸骨，手术创伤大，患者恢复慢，并发症多。经单侧胸壁胸腔镜纵隔肿瘤切除术减少了手术创伤，加速了患者恢复。但是对于对侧胸腺以及心包旁脂肪的切除并不顺利。2016年11月，我们设计研发了一套悬吊双拉钩，至2016年12月，开展悬吊双拉钩法胸腔镜剑突下全胸腺切除术共17例。
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参考文献
[1]
Jaretzki AR . Thymectomy for myasthenia gravis: analysis of controversies--patient management[J]. Neurologist， 2003，9(2):77-92. doi：
10.1097/01.nrl.0000051446.03160.2e
.
[2]
Deeb ME , Brinster CJ , Kucharzuk J ,et al. Expanded indications for transcervical thymectomy in the management of anterior mediastinal masses[J]. Ann Thorac Surg，
20
01
，72(1):208-211.
[3]
Blalock A , Mason MF , Morgan HJ ,et al. Myasthenia gravis and tumors of the thymic region: report of a case in which the tumor was removed[J]. Ann Surg， 1939，110(4):544-561.
[4]
Keynes G . The surgery of the thymus gland[J]. Br J Surg， 1946，33:201-214.
[5]
Clagett OT , Eaton LM . Surgical treatment of myasthenia gravis[J]. J Thorac Surg， 1947，16(1):62-80.
[6]
Detterbeck FC , Moran C , Huang J ,et al. Which way is up? Policies and procedures for surgeons and pathologists regarding resection specimens of thymic malignancy[J]. J Thorac Oncol， 2011，6(7):Suppl 3-S1730. S1738doi：
10.1097/JTO.0b013e31821ea567
.
[7]
Rosenberg M , Jauregui WO , Herrera MR ,et al. Recurrence of thymic hyperplasia after trans-sternal thymectomy in myasthenia gravis[J]. Chest， 1986，89(6):888-889.
[8]
Miller RG , Filler-Katz A , Kiprov D ,et al. Repeat thymectomy in chronic refractory myasthenia gravis[J]. Neurology， 1991，41(6):923-924.
[9]
Jaretzki AR , Penn AS , Younger DS ,et al. " Maximal" thymectomy for myasthenia gravis. Results[J]. J Thorac Cardiovasc Surg， 1988，95(5):747-757.
[10]
Monden Y , Nakahara K , Fujii Y ,et al. Myasthenia gravis in elderly patients[J]. Ann Thorac Surg， 1985，39(5):433-436.
[11]
Kagotani K , Monden Y , Nakahara K ,et al. Anti-acetylcholine receptor antibody titer with extended thymectomy in myasthenia gravis[J]. J Thorac Cardiovasc Surg， 1985，90(1):7-12.
[12]
Olanow CW , Wechsler AS , Sirotkin-Roses M ,et al. Thymectomy as primary therapy in myasthenia gravis[J]. Ann N Y Acad Sci， 1987，505:595-606.
[13]
Fischer JE , Grinvalski HT , Nussbaum MS ,et al. Aggressive surgical approach for drug-free remission from myasthenia gravis[J]. Ann Surg， 1987，205(5):496-503.
[14]
Hatton PD , Diehl JT , Daly BD ,et al. Transsternal radical thymectomy for myasthenia gravis: a 15-year review[J]. Ann Thorac Surg， 1989，47(6):838-840.
[15]
Mulder DG , Graves M , Herrmann C . Thymectomy for myasthenia gravis: recent observations and comparisons with past experience[J]. Ann Thorac Surg， 1989，48(4):551-555.
[16]
Fujii N , Itoyama Y , Machi M ,et al. Analysis of prognostic factors in thymectomized patients with myasthenia gravis: correlation between thymic lymphoid cell subsets and postoperative clinical course[J]. J Neurol Sci， 1991，105(2):143-149.
[17]
Nussbaum MS , Rosenthal GJ , Samaha FJ ,et al. Management of myasthenia gravis by extended thymectomy with anterior mediastinal dissection[J]. Surgery， 1992，112(4):681-688.
[18]
Frist WH , Thirumalai S , Doehring CB ,et al. Thymectomy for the myasthenia gravis patient: factors influencing outcome[J]. Ann Thorac Surg， 1994，57(2):334-338.
[19]
Masaoka A , Yamakawa Y , Niwa H ,et al. Extended thymectomy for myasthenia gravis patients: a 20-year review[J]. Ann Thorac Surg， 1996，62(3):853-859.
[20]
Bulkley GB , Bass KN , Stephenson GR ,et al. Extended cervicomediastinal thymectomy in the integrated management of myasthenia gravis[J]. Ann Surg， 1997，226(3):324-335.
[21]
Detterbeck FC , Scott WW , Howard JJ ,et al. One hundred consecutive thymectomies for myasthenia gravis[J]. Ann Thorac Surg， 1996，62(1):242-245.
[22]
Jun Y , Hao L , Demin L ,et al. Da Vinci robot-assisted system for thymectomy: experience of 55 patients in China[J]. Int J Med Robot， 2014，10(3):294-299. doi：
10.1002/rcs.1577
.
[23]
Kark AE , Kirschner PA . Total thymectomy by the transcervical approach[J]. Br J Surg， 1971，58(5):321-326.
[24]
Kark AE , Papatestas AE . Some anatomic features of the transcervical approach for thymectomy[J]. Mt Sinai J Med， 1971，38(6):580-585.
[25]
Henze A , Biberfeld P , Christensson B ,et al. Failing transcervical thymectomy in myasthenia gravis. An evaluation of transsternal re-exploration[J]. Scand J Thorac Cardiovasc Surg， 1984，18(3):235-238.
[26]
Masaoka A , Monden Y , Seike Y ,et al. Reoperation after transcervical thymectomy for myasthenia gravis[J]. Neurology， 1982，32(1):83-85.
[27]
Rosenberg M , Jauregui WO , De Vega ME ,et al. Recurrence of thymic hyperplasia after thymectomy in myasthenia gravis. Its importance as a cause of failure of surgical treatment[J]. Am J Med， 1983，74(1):78-82.
[28]
Kornfeld P , Merav A , Fox S ,et al. How reliable are imaging procedures in detecting residual thymus after previous thymectomy？[J]. Ann N Y Acad Sci， 1993，681:575-576.
[29]
Cooper JD , Al-Jilaihawa AN , Pearson FG ,et al. An improved technique to facilitate transcervical thymectomy for myasthenia gravis[J]. Ann Thorac Surg， 1988，45(3):242-247.
[30]
Bril V , Kojic J , Ilse WK ,et al. Long-term clinical outcome after transcervical thymectomy for myasthenia gravis[J]. Ann Thorac Surg， 1998，65(6):1520-1522. doi：
10.1016/S0003-4975(98)00184-2
.
[31]
Calhoun RF , Ritter JH , Guthrie TJ ,et al. Results of transcervical thymectomy for myasthenia gravis in 100 consecutive patients[J]. Ann Surg， 1999，230(4):555-561.
[32]
Meyers BF , Cooper JD . Transcervical thymectomy for myasthenia gravis[J]. Chest Surg Clin N Am， 2001，11(2):363-368.
[33]
Shrager JB , Deeb ME , Mick R ,et al. Transcervical thymectomy for myasthenia gravis achieves results comparable to thymectomy by sternotomy[J]. Ann Thorac Surg， 2002，74(2):320-327. doi：
10.1016/S0003-4975(02)03722-0
.
[34]
Jaretzki AR , Barohn RJ , Ernstoff RM ,et al. Myasthenia gravis: recommendations for clinical research standards. Task force of the medical scientific advisory board of the myasthenia gravis foundation of america[J]．Ann Thorac Surg， 2000，70(1):327-334. doi：
10.1016/S0003-4975(00)01595-2
.
[35]
Jaretzki AR , Wolff M .
" Maximal" thymectomy for myasthenia gravis. Surgical anatomy and opera
tive technique
[J]. J Thorac Cardiovasc Surg， 1988，96(5):711-716.
[36]
Mack MJ , Landreneau RJ , Yim AP ,et al. Results of video-assisted thymectomy in patients with myasthenia gravis[J]. J Thorac Cardiovasc Surg， 1996，112(5):1352-1360.
[37]
Sugarbaker DJ . Thoracoscopy in the management of anterior mediastinal masses[J]. Ann Thorac Surg， 1993，56(3):653-656.
[38]
Roviaro G , Rebuffat C , Varoli F ,et al. Videothoracoscopic excision of mediastinal masses: indications and technique[J]. Ann Thorac Surg， 1994，58(6):1679-1684.
[39]
Sabbagh MN , Garza JS , Patten B . Thoracoscopic thymectomy in patients with myasthenia gravis[J]. Muscle Nerve， 1995，18(12):1475-1477.
[40]
Yim AP , Kay RL , Ho JK . Video-assisted thoracoscopic thymectomy for myasthenia gravis[J]. Chest， 1995，108(5):1440-1443.
[41]
Mineo TC , Pompeo E , Ambrogi V ,et al. Adjuvant pneumomediastinum in thoracoscopic thymectomy for myasthenia gravis[J]. Ann Thorac Surg， 1996，62(4):1210-1212.
[42]
Ruckert JC , Gellert K , Muller JM . Operative technique for thoracoscopic thymectomy[J]. Surg Endosc， 1999，13(9):943-946.
[43]
Mack MJ . Video-assisted thoracoscopy thymectomy for myasthenia gravis[J]. Chest Surg Clin N Am， 2001，11(2):389-405.
[44]
Shigemura N , Shiono H , Inoue M ,et al.
Inclusion of the transcervical approach in video-assisted thoracoscopic extend
ed thymectomy(VATET) for myasthenia gravis: a prospective trial
[J]. Surg Endosc， 2006，20(10):1614-1618. doi：
10.1007/s00464-005-0614-7
.
[45]
Shiono H , Shigemura N , Okumura M . Inclusion of the transcervical approach in video-assisted thoracoscopic extended thymectomy(VATET) for myasthenia gravis: a prospective trial[J]. Surg Endosc， 2008，22(4):1135-1136. doi：
10.1007/s00464-008-9767-5
.
[46]
Takeo S , Sakada T , Yano T . Video-assisted extended thymectomy in patients with thymoma by lifting the sternum[J]. Ann Thorac Surg， 2001，71(5):1721-1723. doi：
10.1016/S0003-4975(00)02697-7
.
[47]
Takeo S , Tsukamoto S , Kawano D ,et al. Outcome of an original video-assisted thoracoscopic extended thymectomy for thymoma[J]. Ann Thorac Surg， 2011，92(6):2000-2005. doi：
10.1016/j.athoracsur.2011.07.054
.
[48]
Zielinski M . Technique of transcervical--subxiphoid-vats " maximal" thymectomy in treatment of myasthenia gravis[J]. Przegl Lek， 2000，57(Suppl 5):64-65.
[49]
Zielinski M , Kuzdzal J , Szlubowski A ,et al. Transcervical-subxiphoid-videothoracoscopic " maximal" thymectomy--operative technique and early results[J]. Ann Thorac Surg， 2004，78(2):404-410. doi：
10.1016/j.athoracsur.2004.02.021
.
[50]
Yoshino I , Hashizume M , Shimada M ,et al. Thoracoscopic thymomectomy with the da Vinci computer-enhanced surgical system[J]. J Thorac Cardiovasc Surg， 2001，122(4):783-785. doi：
10.1067/mtc.2001.115231
.
[51]
Bodner J , Lottersberger CA , Kirchmayr W ,et al.
Ectopi
c mediastinal thyroid adenoma
[J]. Eur J Cardiothorac Surg， 2004，26(1):211-212. doi：
10.1016/j.ejcts.2004.04.001
.
[52]
Bodner J , Wykypiel H , Wetscher G ,et al. First experiences with the da Vinci operating robot in thoracic surgery[J]. Eur J Cardiothorac Surg， 2004，25(5):844-851. doi：
10.1016/j.ejcts.2004.02.001
.
[53]
Ruckert JC , Swierzy M , Ismail M . Comparison of robotic and nonrobotic thoracoscopic thymectomy: a cohort study[J]. J Thorac Cardiovasc Surg， 2011，141(3):673-677. doi：
10.1016/j.jtcvs.2010.11.042
.
[54]
Marulli G , Schiavon M , Perissinotto E ,et al. Surgical and neurologic outcomes after robotic thymectomy in 100 consecutive patients with myasthenia gravis[J]. J Thorac Cardiovasc Surg， 2013，145(3):730-736. doi：
10.1016/j.jtcvs.2012.12.031
.
[55]
Rea F , Marulli G , Bortolotti L ,et al. Experience with the " da Vinci" robotic system for thymectomy in patients with myasthenia gravis: report of 33 cases[J]. Ann Thorac Surg， 2006，81(2):455-459. doi：
10.1016/j.athoracsur.2005.08.030
.
[56]
Rea F , Schiavon M , Marulli G . Robotic thymectomy for myasthenia gravis[J]. Ann Cardiothorac Surg， 2015，4(6):558-560. doi：
10.3978/j.issn.2225-319X.2015.09.02
.
[57]
Zhao Y , Jiao W , Qiu T ,et al. Robotic thymectomy in patients with myasthenia gravis by vascular skeletonization[J]. Ann Transl Med， 2015，3(14):200. doi：
10.3978/j.issn.2305-5839.2015.03.67
.
[58]
Freeman RK , Ascioti AJ , Van Woerkom JM ,et al. Long-term follow-up after robotic thymectomy for nonthymomatous myasthenia gravis[J]. Ann Thorac Surg， 2011，92(3):1018-1023. doi：
10.1016/j.athoracsur.2011.04.054
.
[59]
宋楠，赵德平，蒋雷，等. 经剑突下单孔胸腔镜肺切除术93例[J]. 中华胸心血管外科杂志， 2016，32(3):129-131. doi：
10.3760/cma.j.issn.1001-4497.2016.03.001
.
Song N , Zhao DP , Jiang L ,et al. Subxiphoid uniportal video-assisted thoracoscopic surgery(VATS) for lung resection: a report of 93 cases[J]. Chin J Thorac Cardiovasc Surg, 2016，32(3):129-131. doi：
10.3760/cma.j.issn.1001-4497.2016.03.001
.
[60]
吴伟斌，曾贵青，吕文强. 剑突下单孔胸腔镜手术在前纵隔肿瘤切除中的应用[J]. 中国实用医药， 2016，11(19):54-55. doi：
10.14163/j.cnki.11-5547/r.2016.19.033
.
Wu WB , Zeng GQ , Lv WQ . Appilication of subxiphoid uniportal video-assisted thoracoscopic surgery in resection of anterior mediastinal tumors[J]．Chin Pract Med， 2016，11(19):54-55. doi：
10.14163/j.cnki.11-5547/r.2016.19.033
.
[61]
Tang X , Liang Y . Clinical appilication of subxiphoid uniportal video-assisted thoracoscopic surgery[J]. Gangdong Med J, 2016，37(z2):131-132. doi：
10.13820/j.cnki.gdyx.2016.s1.057
.
[62]
卢强，李小飞，赵晋波，等. "三孔式"经剑突肋缘下胸腺切除治疗重症肌无力[J]. 中华胸部外科电子杂志， 2016，3(2):95-99. doi：
10.3877/cma.j.issn.2095-8773.2016.02.006
.
Lu Q , Li XF , Zhao JB ,et al. Thymus resection with " three holes" operation through subxiphoid and subcostal in the treatment of myasthenia gravis[J]. Chin J Thorac Surg， 2016，3(2):95-99. doi：
10.3877/cma.j.issn.2095-8773.2016.02.006
.
[63]
卢强，李小飞，陈召，等. 新型"三孔式"微创术式治疗重症肌无力[J]. 中华胸心血管外科杂志， 2016，32(5):287-288. doi：
10.3760/cma.j.issn.1001-4497.2016.05.008
.
Lu Q , Li XF , Chen Z ，et al.
Clinical research of safety and effectiveness of the thym
us expand resection with new" three holes" minimally invasive operation in the treatment of myasthenia gravis
[J]. Chin J Thorac Cardiovasc Surg, 2016，32(5):287-288. doi：
10.3760/cma.j.issn.1001-4497.2016.05.008
.
[64]
Akamine S , Takahashi T , Oka T ,et al. Thymic cystectomy through subxyphoid by video-assisted thoracic surgery[J]. Ann Thorac Surg， 1999，68(6):2339-2341. doi：
10.1016/S0003-4975(99)01164-9
.
[65]
Zielinski M , Czajkowski W , Gwozdz P ,et al.
Resection of thymomas with use of the new minimally-invasive technique of extended thymectomy performed through the subxiphoid-right video-th
oracoscopic approach with double elevation of the sternum
[J]. Eur J Cardiothorac Surg， 2013，44(2):e113-e119. doi：
10.1093/ejcts/ezt224
.
[66]
Suda T , Kaneda S , Hachimaru A ,et al. Thymectomy via a subxiphoid approach: single-port and robot-assisted[J]. J Thorac Dis， 2016，8(Suppl 3):S265-S271. doi：
10.3978/j.issn.2072-1439.2016.02.34
.
[67]
汪灏，李继军，丁建勇，等. 胸骨抬举法辅助经剑突下胸腔镜微创手术治疗胸腺病变的初步尝试[J]. 中国临床医学， 2017，24(2):188-190. doi：
10.12025/j.issn.1008-6358.2017.20170067
.
Wang H , Li JJ , Ding JY ,et al. Primary experience of subxiphoid thoracoscopic approach for minimally invasive thymectomy assisted by sternum-elevating technique[J]．Chin J Clin Med， 2017，24(2):188-190. doi：
10.12025/j.issn.1008-6358.2017.20170067
.
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