Clinical Analysis Of Video-assisted Thoracoscopic Surgery And Traditional Sternal Splitting Treatment Of Thymoma With Myasthenia Gravis

Objective Compared clinical effect of the treatment of thymictumors combined with myasthenia gravis between video-assistedthoracic surgery (VATS) and sternal median incision extended resection,and select reasonable operation methods for exploring the value ofclinical application of the video-assisted thoracic extended surgery.Methods A retrospective analysis in Jun2008to Nov2013forclinical data of195cases of myasthenia gravis patients via thymectomy,according to the different operation were divided into VATS group (2012Mar to2013Nov,80cases) and sternal median incision group (2008Junto2013Jul,110cases). The operation time, bleeding volume,postoperative drainage, storm duration (myasthenia gravis crisis whenthe mechanical ventilation time) are analyzed via independent t test.Using X2test analysis for postoperative myasthenic crisis incidence rate,two groups of patients were thymectomized and cleaning of adiposetissue of anterior mediastinum.Results bleeding volumes of VATS group in the operation are lessthan the median incision thoracotomy group (53.24±11.69ml and97.37±24.61ml, P<0.05); postoperative myasthenic crisis incidence rateof VATS group was5.0%(4/80), median thoracotomy group was13.64%(15/110), there was statistically significant difference betweentwo groups (P<0.05). VATS group after crisis required mechanical ventilation time are shorter than the median thoracotomy group (75.33±39.31h±89.74h, vs.189.20, P<0.05); VATS group are none crisis formyasthenia gravis in perioperative stage, sternotomy group occurred in8cases of crisis of myasthenia gravis in perioperative stage, two groups ofpatients did not have death in the perioperative operation period. In theVATS group, The amount of bleeding, postoperative chest drainage time,postoperative hospitalization time, ICU monitoring time are decreasedthan thoracotomy group, there was significant difference between2groups (P<0.05); the2groups of operation time didnot have significantdifference (P>0.05).Conclusion VATS extended thymectomy for treating myastheniagravis, there are good safety, less bleeding, small operation wound, canreduce the occurrence of myasthenia crisis after operation, shorten theduration of mechanical ventilation in postoperative myasthenia graviscrisis required, and has a good application prospect.