Single-utility Port Video-assisted Thoracoscopic Extended Thymectomy for Myasthenia Gravis: Report of 45 Patients
Backgroud and objective Thymectomy plays an important role in patients with myasthenia gravis (MG) and video-assisted thoracoscopic (VATS) extended thymectomy has been widely used in recent years. The traditional thoracoscopic procedure requires three intercostal incisions. Our study improved the su...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Chinese Anti-Cancer Association; Chinese Antituberculosis Association
2020-03-01
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| Series: | Chinese Journal of Lung Cancer |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.3779/j.issn.1009-3419.2020.03.04 |
| _version_ | 1818514285345636352 |
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| author | Chuan HUANG Hongfeng TONG Yaoguang SUN Qingjun WU Chao MA Peng JIAO Wenxin TIAN Hanbo YU Wen HUANG Yongzhong WANG |
| author_facet | Chuan HUANG Hongfeng TONG Yaoguang SUN Qingjun WU Chao MA Peng JIAO Wenxin TIAN Hanbo YU Wen HUANG Yongzhong WANG |
| author_sort | Chuan HUANG |
| collection | DOAJ |
| description | Backgroud and objective Thymectomy plays an important role in patients with myasthenia gravis (MG) and video-assisted thoracoscopic (VATS) extended thymectomy has been widely used in recent years. The traditional thoracoscopic procedure requires three intercostal incisions. Our study improved the surgical approach and operation method by using single-utility port thoracoscopy. The aim of this study was to evaluate the effect of single-utility port VATS extended thymectomy for MG. Methods A retrospective analysis was performed in 45 patients with MG who underwent single-utility port VATS extended thymectomy in Beijing Hospital from July 2017 to December 2018. The safety and effectiveness of this surgical approach were summarized. Results All operations were accomplished successfully, without conversion to thoracotomy, requirement of additional incisions or postoperative death. The mean operation time was (141.3±39.2) min; the mean intraoperative blood loss was (64.2±45.5) mL; the median thoracic drainage duration was 3 days (range 2 days to 8 days); the mean pleural drainage was (890.4±439.1) mL, and the median postoperative hospital stay was 6 days (range 3 days to 91 days). There were 13 cases (28.9%) with postoperative complications, including 5 cases (11.1%) with myasthenia crisis, 6 cases (13.3%) with pulmonary complications, 4 cases (8.9%) with poor incision healing, 4 cases (8.9%) with atrial fibrillation, and 1 case (2.2%) with delayed pericardial hemorrhage. The median follow-up time was 18.5 months (range 12.5 months to 29.2 months). According to the effect of 1 year after surgery, 1 case (2.2%) showed pharmacologic remission; 18 cases (40.0%) showed minimal manifestations; 23 cases (51.1%) got improvement; 1 case (2.2%) showed no changs and 2 cases (4.4%) were worse. Conclusion Single-utility port VATS extended thymectomy is a safe and feasible minimally invasive procedure for MG. During the perioperative period, special attention should be paid to prevent myasthenic crisis, pulmonary complications, and incision complications. |
| first_indexed | 2024-12-11T00:13:38Z |
| format | Article |
| id | doaj.art-72794545a4de4934ab76aadffbf5a2ac |
| institution | Directory Open Access Journal |
| issn | 1009-3419 1999-6187 |
| language | zho |
| last_indexed | 2024-12-11T00:13:38Z |
| publishDate | 2020-03-01 |
| publisher | Chinese Anti-Cancer Association; Chinese Antituberculosis Association |
| record_format | Article |
| series | Chinese Journal of Lung Cancer |
| spelling | doaj.art-72794545a4de4934ab76aadffbf5a2ac2022-12-22T01:28:03ZzhoChinese Anti-Cancer Association; Chinese Antituberculosis AssociationChinese Journal of Lung Cancer1009-34191999-61872020-03-0123315616110.3779/j.issn.1009-3419.2020.03.04Single-utility Port Video-assisted Thoracoscopic Extended Thymectomy for Myasthenia Gravis: Report of 45 PatientsChuan HUANG0Hongfeng TONG1Yaoguang SUN2Qingjun WU3Chao MA4Peng JIAO5Wenxin TIAN6Hanbo YU7Wen HUANG8Yongzhong WANG9Department of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, ChinaDepartment of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, ChinaDepartment of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, ChinaDepartment of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, ChinaDepartment of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, ChinaDepartment of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, ChinaDepartment of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, ChinaDepartment of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, ChinaDepartment of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, ChinaDepartment of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, ChinaBackgroud and objective Thymectomy plays an important role in patients with myasthenia gravis (MG) and video-assisted thoracoscopic (VATS) extended thymectomy has been widely used in recent years. The traditional thoracoscopic procedure requires three intercostal incisions. Our study improved the surgical approach and operation method by using single-utility port thoracoscopy. The aim of this study was to evaluate the effect of single-utility port VATS extended thymectomy for MG. Methods A retrospective analysis was performed in 45 patients with MG who underwent single-utility port VATS extended thymectomy in Beijing Hospital from July 2017 to December 2018. The safety and effectiveness of this surgical approach were summarized. Results All operations were accomplished successfully, without conversion to thoracotomy, requirement of additional incisions or postoperative death. The mean operation time was (141.3±39.2) min; the mean intraoperative blood loss was (64.2±45.5) mL; the median thoracic drainage duration was 3 days (range 2 days to 8 days); the mean pleural drainage was (890.4±439.1) mL, and the median postoperative hospital stay was 6 days (range 3 days to 91 days). There were 13 cases (28.9%) with postoperative complications, including 5 cases (11.1%) with myasthenia crisis, 6 cases (13.3%) with pulmonary complications, 4 cases (8.9%) with poor incision healing, 4 cases (8.9%) with atrial fibrillation, and 1 case (2.2%) with delayed pericardial hemorrhage. The median follow-up time was 18.5 months (range 12.5 months to 29.2 months). According to the effect of 1 year after surgery, 1 case (2.2%) showed pharmacologic remission; 18 cases (40.0%) showed minimal manifestations; 23 cases (51.1%) got improvement; 1 case (2.2%) showed no changs and 2 cases (4.4%) were worse. Conclusion Single-utility port VATS extended thymectomy is a safe and feasible minimally invasive procedure for MG. During the perioperative period, special attention should be paid to prevent myasthenic crisis, pulmonary complications, and incision complications.http://dx.doi.org/10.3779/j.issn.1009-3419.2020.03.04myasthenia gravisextended thymectomyvideo-assisted thoracoscopic surgerysingle-utility port |
| spellingShingle | Chuan HUANG Hongfeng TONG Yaoguang SUN Qingjun WU Chao MA Peng JIAO Wenxin TIAN Hanbo YU Wen HUANG Yongzhong WANG Single-utility Port Video-assisted Thoracoscopic Extended Thymectomy for Myasthenia Gravis: Report of 45 Patients Chinese Journal of Lung Cancer myasthenia gravis extended thymectomy video-assisted thoracoscopic surgery single-utility port |
| title | Single-utility Port Video-assisted Thoracoscopic Extended Thymectomy for Myasthenia Gravis: Report of 45 Patients |
| title_full | Single-utility Port Video-assisted Thoracoscopic Extended Thymectomy for Myasthenia Gravis: Report of 45 Patients |
| title_fullStr | Single-utility Port Video-assisted Thoracoscopic Extended Thymectomy for Myasthenia Gravis: Report of 45 Patients |
| title_full_unstemmed | Single-utility Port Video-assisted Thoracoscopic Extended Thymectomy for Myasthenia Gravis: Report of 45 Patients |
| title_short | Single-utility Port Video-assisted Thoracoscopic Extended Thymectomy for Myasthenia Gravis: Report of 45 Patients |
| title_sort | single utility port video assisted thoracoscopic extended thymectomy for myasthenia gravis report of 45 patients |
| topic | myasthenia gravis extended thymectomy video-assisted thoracoscopic surgery single-utility port |
| url | http://dx.doi.org/10.3779/j.issn.1009-3419.2020.03.04 |
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