Transcervical excision of thymoma and video-assisted thoracoscopic extended thymectomy (VATET) for ectopic cervical thymoma with myasthenia gravis: report of a case

2015 ◽  
Vol 64 (12) ◽  
pp. 752-754 ◽  
Author(s):  
Sachiko Kumazawa ◽  
Hironori Ishibashi ◽  
Ken Takahashi ◽  
Kenichi Okubo
Keyword(s):  
Myasthenia Gravis ◽  
Extended Thymectomy ◽  
Video Assisted

Myasthenia gravis miatt végzett három különböző típusú csecsemőmirigy-eltávolítás sebészeti és korai neurológiai eredményei

2015 ◽  
Vol 68 (6) ◽  
pp. 219-224
Author(s):  
Aurél Ottlakán ◽  
Tibor Géczi ◽  
Balázs Pécsy ◽  
Bernadett Borda ◽  
Judit Lantos ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Thoracoscopic Surgery ◽  
Extended Thymectomy ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Absztrakt Célkitűzés: A myasthenia gravis (MG) kezelésében számos nyitott, illetve minimálisan invazív thymectomia ismert. A tanulmány ugyanazon intézeten belül a transsternalis (TS), illetve kétféle minimálisan invazív thymectomia (video-assisted thoracoscopic extended thymectomy – VATET; unilateral video-assisted thoracoscopic surgery – UL-VATS) eredményeit hasonlítja össze. Anyag és módszerek: Három különböző időintervallumban 71 betegnél történt thymectomia MG miatt (60 nő, 11 férfi): 23 transsternalis thymectomia (1995. január–2004. szeptember), 22 VATET (2004. szeptember – 2009. augusztus) és 26 UL-VATS thymectomia (2009. szeptember – 2011. december). Az eredmények értékelésénél a műtéti idő, MG-hez társuló neurológiai és a műtét utáni sebészi szövődmények, valamint az MG státuszában az egyéves utánkövetéskor észlelt neurológiai változások szerepeltek. Eredmények: Perioperatív mortalitás nem fordult elő. A műtéti idő 112, 211, 116 perc (p = 0,001), a kórházi napok száma: 8,9, 5,6 és 4 nap (p = 0,001) volt a TS-, VATET- és UL-VATS-csoportban. Az MG-hez kapcsolódó postoperativ neurológiai szövődmények 21,7%, 18,2% és 7,7% (p = 0,365) értékeket mutattak. A sebészi szövődmény 4,3%, 13,7%, 0% (p = 0,118) volt. Az MG tüneteinek javulása 91,3%, 94,7%, 87,5% (p = 0,712), míg komplett remisszió 13%, 10,5%, 11,5% (p = 0,917) volt a TS-, VATET- és UL-VATS-csoportokban. Következtetések: A műtéti idő, valamint a kórházban eltöltött napok száma UL-VATS esetében volt a legrövidebb. A kisebb sebészi beavatkozáshoz alacsonyabb sebészi, illetve MG-s neurológiai szövődmények társultak. Az MG-tünetek javulásában mindhárom módszernél kiváló eredményt értek el.

Video-assisted thoracoscopic extended thymectomy and extended transsternal thymectomy (T-3b) in non-thymomatous myasthenia gravis patients: remission after 6 years of follow-up

2003 ◽  
Vol 212 (1-2) ◽  
pp. 31-36 ◽  
Author(s):  
Renato Mantegazza ◽  
Fulvio Baggi ◽  
Pia Bernasconi ◽  
Carlo Antozzi ◽  
Paolo Confalonieri ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Extended Thymectomy ◽  
Video Assisted

scholarly journals Two-Lung Ventilation: A Safer and More Efficient Method Than One-Lung Ventilation in Bilateral Video-Assisted Thoracoscopic Extended Thymectomy in Myasthenia Gravis

2021 ◽  
Author(s):  
Mijung Yun ◽  
Gunn Hee Kim ◽  
Sung-chul Ko ◽  
Wooshik Kim
Keyword(s):  
Myasthenia Gravis ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Extended Thymectomy ◽  
Time Points ◽  
Video Assisted ◽  
Hemodynamic Variables ◽  
Duration Of Surgery ◽  
Anesthesia Time ◽  
Group D

Abstract Background Myasthenia gravis (MG) is an autoimmune disease and early thymectomy has been recommended. After the introduction of VATS, the safety and effectiveness of carbon dioxide (CO2) insufflation in thoracic cavity (capnothorax) has been continuously controversial. This study aimed to compare the safety and effectiveness of ventilation methods in bilateral video-assisted thoracoscopic extended thymectomy (BVET) with capnothorax.Methods We retrospectively investigated the medical records of MG patients who underwent BVET between August 2016 and January 2018.Patients were divided into two groups: group D (n=26) for one-lung ventilation and group S (n=28) for two lung-ventilation. We set nine anesthesia time points (T0–T8) and collected respiratory and hemodynamic variables including arterial O2 index (PaO2/FiO2).Results The EtCO2 at T0, T1–T4, and T7 were insignificantly higher in group D than those in group S. The SpO2 at T1–T3 and T8 were significantly lower in group D than those in group S. The FiO2 in group S was lower than that in group D at all-time points. The number of PaO2/FiO2 ≤ 300 and PaO2/FiO2 ≤ 200 were significantly higher in group D than those in group S. Hemodynamic variables were not insignificantly different between the two groups at all-time points. The duration of surgery and anesthesia was shorter in group S than that in group D. Conclusions This retrospective study suggests that anesthesia using two-lung ventilation during BVET with capnothorax was a safe and effective method to improve lung oxygenation and reduce the operation and anesthesia time.

The entire technique of bilateral uniportal video-assisted sequential thoracoscopic extended thymectomy in a patient with myasthenia gravis and thymic hypertrophy

ASVIDE ◽  
2017 ◽  
Vol 4 ◽  
pp. 201-201
Author(s):  
Francesco Paolo Caronia ◽  
Ettore Arrigo ◽  
Sebastiano Trovato ◽  
Attilio Ignazio Lo Monte ◽  
Salvatore Cottone ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Extended Thymectomy ◽  
Video Assisted

Inclusion of the transcervical approach in video-assisted thoracoscopic extended thymectomy (VATET) for myasthenia gravis: a prospective trial

2006 ◽  
Vol 20 (10) ◽  
pp. 1614-1618 ◽  
Author(s):  
N. Shigemura ◽  
H. Shiono ◽  
M. Inoue ◽  
M. Minami ◽  
M. Ohta ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Prospective Trial ◽  
Extended Thymectomy ◽  
Transcervical Approach ◽  
Video Assisted

Video-assisted Thoracoscopic Extended Thymectomy (VATET) in Myasthenia Gravis Two-Year Follow-up in 101 Patients and Comparison with the Transsternal Approach

1998 ◽  
Vol 841 (1 MYASTHENIA GR) ◽  
pp. 749-752 ◽  
Author(s):  
R. MANTEGAZZA ◽  
P. CONFALONIERI ◽  
C. ANTOZZI ◽  
L. NOVELLINO ◽  
M. T. FERRO ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Extended Thymectomy ◽  
Video Assisted

Bilateral single-port video-assisted thoracoscopy for extended thymectomy in the treatment of myasthenia gravis

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Gia Khánh Ngô ◽  
Hữu Ước Nguyễn ◽  
Trọng Kiểm Trần
Keyword(s):  
Postoperative Pain ◽  
Myasthenia Gravis ◽  
Single Port ◽  
Intercostal Space ◽  
Lateral Decubitus Position ◽  
Pathological Examination ◽  
Extended Thymectomy ◽  
Video Assisted ◽  
Left Lateral Decubitus Position ◽  
Lateral Decubitus

Tóm tắt Đặt vấn đề: Phẫu thuật nội soi lồng ngực đã được sử dụng rộng rãi trong điều trị các khối u trung thất trước trong đó có u tuyến ức. Xu hướng hiện nay là ngày càng giảm số “lỗ” và hạn chế độ dài đường rạch nhằm mục tiêu giảm đau sau mổ, giảm dị cảm thành ngực và giảm thời gian nằm viện. Trong báo cáo này, chúng tôi thông báo một trường hợp cắt tuyến ức mở rộng ở một người bệnh nhược cơ bằng phẫu thuật nội soi một lỗ. Phương pháp nghiên cứu: Người bệnh nam 55 tuổi, được chẩn đoán nhược cơ, trên CT: khối u tuyến ức đường kính (ĐK) 3cm. Các thăm dò khác trước mổ bình thường. Người bệnh được chỉ định mổ cắt tuyến ức nội soi lồng ngực một lỗ hai bên. Người bệnh được gây mê toàn thân, sử dụng ống nội khí quản hai nòng. Người bệnh nằm ngửa được cố định vững vào bàn mổ, nghiêng bàn khoảng 600 sang bên phải khi thao tác. Rạch da 3cm khoang liên sườn 4 đường nách giữa, qua đường rạch đưa ống kính nội soi 300 và dụng cụ vào để thao tác, không sử dụng banh sườn. Tiến hành phẫu tích từ bên phải trước, sau khi tuyến ức và tổ chức mỡ trung thất được giải phóng, mở màng phổi trung thất đối bên và qua đó đẩy bệnh phẩm sang bên trái. Sau đó, nghiêng bàn mổ sang bên đối diện. Tương tự như bên phải, rạch da ở vị trí khoang liên sườn 4 dài 3cm. Phẫu tích lấy toàn bộ tổ chức mỡ trung thất và thùy trái tuyến ức và lấy bệnh phẩm. Kết quả: Không gặp biến chứng trong và sau mổ. Người bệnh xuất viện sau 5 ngày. Giải phẫu bệnh Thymoma typ A (Masaoka I). Không có tái phát sau 18 tháng theo dõi. Kết luận: Phẫu thuật nội soi lồng ngực một lỗ hai bên có thể áp dụng hiệu quả trong cắt tuyến ức mở rộng điều trị nhược cơ. Giảm đau sau mổ, giảm thời gian nằm viện và tốt hơn về mặt thẩm mỹ là những ưu điểm của phương pháp này so với các phẫu thuật truyền thống. Abstract Introduction: Video-assisted thoracoscopy is become a widely accepted approach for the resection of anterior mediastinal masses, including thymoma. The current trend is to reduce the number of ports and to minimize the length of incision in order to decrease postoperative pain, chest wall paraesthesia and length of hospitalization. Herein, we reported an extended thymectomy in a patient with myasthenia gravis with bilateral single-port thoracoscopy approach. Material and Methods: A 55-years-old woman with myasthenia gravis was referred to our attention for management of a 3.5 cm, well-capsulated thymoma. All laboratory and cardio-pulmonary tests were within the normal limit; thus, thymoma resection with bilateral single-port thoracoscopy approach was scheduled. Under general anaesthesia and selective intubation, the patient was placed in 600 right lateral decubitus position. A 3cm skin incision was performed in the fourth right intercostal space and through that, a 300 camera and working instruments were inserted without rib spreading. After complete dissection of the thymus and mediastinal fat, the contralateral pleura was opened and through that, the specimen was pushed into the left pleural cavity. Then, the patient was placed in the left lateral decubitus position. Similarly to the right side, a 3-cm incision was performed in the fourth left intercostal space to complete thymoma dissection and the specimen was retrieved. Results: No intra- and post-operative complications were found. The patient was discharged of the hospital in 4th days. Pathological examination revealed a thymoma of type A (Masaoka stage I). No recurrence was found in 18 months of follow-up Conclusion: Bilateral single-port thoracoscopy is an available procedure for management of thymoma associated with myasthenia gravis. Less postoperative pain, reduction of hospital stay and better aesthetic results are the potential advantages of this approach in comparison with traditional technique. Obviously, our results should be validated by larger studies in terms of long-term oncological outcomes. Keyword: Single-port thoracoscopic surgery, thymoma, myasthenia gravis.

Sign in / Sign up

Export Citation Format

Share Document