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目的探讨机器人辅助经剑突下胸腺(扩大)切除手术治疗重症肌无力和胸腺肿瘤的初步经验。方法纳入我院2016年8月至2017年8月胸腺肿瘤和重症肌无力患者62例,其中男34例、女28例,平均年龄(38±11)岁;行机器人辅助经剑突下胸腺切除手术。所有患者均使用4孔完成手术,镜孔位于剑突下方,双侧锁骨中线肋缘下为1#和2#臂操作孔,3#臂操作孔位于腋前线第5或第6肋间隙,胸腺肿瘤患者行全胸腺切除,重症肌无力患者行胸腺扩大切除。结果所有患者均顺利完成手术,平均手术时间(116.0±34.0)min,术中平均出血量(5.6±4.3)ml,术后平均住院时间(4.0±2.2)d。无术中大出血、中转开胸、围手术期死亡及并发症发生。结论机器人辅助经剑突下胸腺(扩大)切除手术安全可行,值得临床推广应用。
Objective To explore the preliminary experience of robotic assisted thyroidectomy (enlarged) thyroidectomy for myasthenia gravis and thymus tumors. Methods Totally 62 patients with thymoma and myasthenia gravis were included in our hospital from August 2016 to August 2017. There were 34 males and 28 females with an average age of (38 ± 11) years. The robotic assisted xiphoid thyroidectomy surgery. All patients underwent surgery with 4 holes. The holes were located below the xiphoid process. The bilateral clavicular midline marginal ribs were 1 # and 2 # arm operation holes. The 3 # arm operation holes were located on the 5th or 6th intercostal space on the axillary line. The thymus Tumor patients underwent total thymectomy, myasthenia gravis patients with enlarged resection. Results All the patients underwent surgery successfully. The average operation time was 116.0 ± 34.0 min, the intraoperative average amount of bleeding was 5.6 ± 4.3 mL and the average postoperative hospital stay was 4.0 ± 2.2 d. No intraoperative hemorrhage, transit thoracotomy, perioperative deaths and complications occurred. Conclusions Robotic assisted resection of the thymus under the xiphoid (enlargement) is safe and feasible, which is worthy of clinical application.