Comparison Between Thoracoscopic Under Artificial Pneumothorax and Conventional Thoracoscopic Extended Thymectomy / 中国微创外科杂志

ABSTRACT

Objective To evaluate the application value of the VATS combined with artificial pneumothorax in extended thymectomy. Methods From March 2013 to November 2014, we completed 45 cases of expanded thymectomy in patients with myasthenia gravis .According to the choice of patients , the surgeries were divided into two groups .The artificial pneumothorax group (24 cases) was given thoracoscopic expanded resection under artificial pneumothorax , while the conventional surgery group (21 cases) was given conventional thoracoscopic surgery .The operation time , intraoperative bleeding , operative field show ( to expose the offside mediastinal fat and cardiophrenic angle fat fully ) and symptom relief were compared between the two groups . Results The operations were successful in all the 45 cases.As compared with the conventional surgery group , the artificial pneumothorax group had shorter operation time [(93.8 ±16.8) min vs.(119.5 ±23.3) min, t=-4.293, P=0.000], less intraoperative hemorrhage [(54.2 ±43.7) ml vs.(92.9 ±41.0) ml, t=-3.048, P=0.004] and better operation exposure [91.7% (22/24) vs.57.1%(12/21),χ2 =7.228, P=0.007].However, there was no significant difference in symptom remission rate between the two groups . Conclusion VATS under artificial pneumothorax for thymus expanded resection can fully expose the operation field , with shorter operation time and less blood loss .