[1]李晓 惠本刚 肖蓉心 姜冠潮 李剑锋 刘军 王俊**.胸腔镜治疗胸腺瘤的安全性及中长期疗效分析[J].中国微创外科杂志,2017,17(3):193-196.
　Li Xiao,Hui Bengang,Xiao Rongxin,et al.Safety and Mid-long Term Follow-up Results of Video-assisted Thoracoscopic Surgery for Thymoma[J].Chinese Journal of Minimally Invasive Surgery,2017,17(3):193-196.
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胸腔镜治疗胸腺瘤的安全性及中长期疗效分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年3期
页码:
193-196
栏目:
临床论著
出版日期:
2017-06-20

文章信息/Info

Title:
Safety and Mid-long Term Follow-up Results of Video-assisted Thoracoscopic Surgery for Thymoma
作者:
李晓 惠本刚 肖蓉心 姜冠潮 李剑锋 刘军 王俊**
北京大学人民医院胸外科，北京100044
Author(s):
Li Xiao;  Hui Bengang;  Xiao Rongxin;  et al.
Department of Thoracic Surgery, Peking University People’s Hospital, Beijing 100044, China
关键词:
胸腔镜手术; 胸腺瘤; 长期随访; 总生存; 无疾病生存
Keywords:
Video-assisted thoracoscopic surgery; Thymoma; Long-term follow-up; Overall survival; Disease free survival
文献标志码:
A
摘要:
目的探讨胸腔镜治疗胸腺瘤的安全性及中长期疗效。方法回顾性分析2001年4月~2014年11月我科胸腔镜治疗胸腺瘤185例资料，并随访生存和复发情况。结果中转开胸7例（3.8%），主要中转开胸原因为肿瘤侵犯大血管（5例）。Masaoka Ⅰ期123例(66.5%)，Ⅱ期37例(20.0%)，Ⅲ期19例(10.3%)，Ⅳ期6例(3.2%)。Masaoka Ⅰ、Ⅱ、Ⅲ、Ⅳ期的R0切除率分别为100%（123/123）、100%（37/37）、89.5%（17/19）、66.7%（4/6）。手术时间（136.5±51.6）min，中位出血量50 ml(10~2500 ml)，术后带管时间（3.2±1.8）d，术后住院时间（5.8±2.9）d。全组无围手术期死亡，术后并发症10例（5.4%）。随访167例（90.3%），中位随访时间44个月（3~174个月）。5年总生存率94.6%，10年总生存率893%。合并重症肌无力45例中成功随访41例，完全缓解9例，部分缓解23例，总体缓解率78.0%（32/41）。结论胸腔镜治疗早期（Masaoka Ⅰ、Ⅱ期）及部分经过选择的晚期（Masaoka Ⅲ、Ⅳ期）胸腺瘤安全有效，且长期疗效满意。胸腔镜胸腺扩大切除治疗胸腺瘤合并重症肌无力疗效满意。
Abstract:
ObjectiveTo analyze the safety and mid-long term follow-up outcomes of video-assisted thoracoscopic surgery (VATS) in the treatment of thymoma. MethodsClinical data and follow-up results of 185 cases of thymoma who underwent VATS between April 2001 and November 2014 were retrospectively collected. ResultsThere were 7 cases converted to open surgery (38%), and the main conversion reason was invasion of great blood vessels (5 cases). There were 123 cases of Masaoka stage Ⅰ(66.5%), 37 cases of stage Ⅱ (20.0%), 19 cases of stage Ⅲ(10.3%), and 6 cases of stage Ⅳ(3.2%), respectively. The R0 resection rates at Masaoka stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ were 100% (123/123), 100% (37/37), 89.5% (17/19), and 66.7% (4/6), respectively. The average operation time was (136.5±51.6) min, the median blood loss was 50 ml (range, 10-2500 ml), the average drainage time was (3.2±1.8) d, and the postoperative hospital stay was (5.8±2.9) days. Postoperative complications happened in 10 cases (5.4%). No perioperative death occurred. Follow-ups for 3-174 months (median, 44 months) were performed in 167 patients (90.3%). The 5-year and 10-year overall survival rates for the whole group were 94.6% and 89.3%, respectively. There were 45 cases accompanied with mysasthenia gravis (MG), 41 of which were fully followed, showing 9 cases of complete response and 23 cases of partial response. The overall response rate was 78.0% (32/41).ConclusionsVATS is safe and effective for early stage (Masaoka Ⅰ/Ⅱ) and selected late stage (Masaoka Ⅲ/Ⅳ) thymomas with satisfied prognosis. The overall response rate of thymoma with MG treated by VATS is relatively high.

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备注/Memo

备注/Memo:
基金项目：国家高技术研究发展计划（863计划）（项目编号：210300028)**通讯作者，E-mail:jwangmd@yahoo.com
更新日期/Last Update: 2017-06-20