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Objective: myasthenia gravis (myasthenia gravis, MG) is a with neuromuscular conduction disorders characterized by autoimmune diseases. Currently, treatment including drugs and thymectomy surgery. The use of drugs such as cholinesterase inhibitors, immunosuppressants, immunoglobulin. Thymectomy by the neck, median sternotomy incision and by the standard posterolateral incision thymectomy, usually via median sternotomy incision surgery. Traditional thoracotomy surgical trauma, more bleeding, circulatory and respiratory function in patients with interference, Over the last decade, with the continuous development and improvement of video-assisted thoracoscopic instruments and equipment, as well as operating experience mature, video-assisted thoracoscopic intrathoracic disease treatment, and gradually replaced the traditional large incision surgery, and there are multiple the thoracoscopic pathways thymectomy reported in this article by video-assisted thoracoscopic thymic extended resection (video-assisted thoracoscopic surgery VATS) and median sternotomy line thymus extensive resection of the efficacy of the treatment of myasthenia gravis, compare, explore the clinical effect of video-assisted thoracoscopic the thymus expand resection in the treatment of myasthenia gravis. Methods: 28 cases of Dalian Medical University, the First Affiliated Hospital from 2001 to 2007 confirmed based on clinical manifestations of Neurology diagnosed as myasthenia gravis with thymic hyperplasia or thymic normal patients by video-assisted thoracoscopic (12 cases) and median sternotomy line thymus extended resection (n = 16) treatment were studied retrospectively compared between the two groups in operative time, blood loss, tracheal extubation time, critical care, chest tube time and postoperative hospital stay, postoperative remission rate differences. Results: video-assisted thoracoscopic surgery (107.5 ± 18.03min), blood loss (37.5 ± 29.38ml), critical care (13.75 ± 7.6h), tracheal extubation time (39.17 ± 29.38min), chest tube time (33.33 ± 21.7h) and postoperative hospital stay (5.25 ± 1.71d). The thoracotomy group operative time (92.5 ± 31.47min), blood loss (100.63 ± 40.08ml), critical care (27.22 ± 13.27h), tracheal extubation time (405 ± 541min), chest tube time (80.5 ± 90.56h) and postoperative hospital stay (10.19 ± 4.61d). Between the two groups in the critical care time to tracheal extubation time, chest tube time and postoperative hospital stay has significant difference. There were no postoperative myasthenic crisis and deaths during hospitalization. (3 to 32) months of postoperative follow-up (16 to 84) months, two groups of remission rates were 92%, 94%, no statistically significant difference. Conclusions: VATS line thymus expand resection is feasible and safe treatment of myasthenia gravis, trauma, beautiful, rapid postoperative recovery, fewer complications, but extensive pleural adhesions and patients can not tolerate one-lung ventilation recommended to thoracotomy appropriate.
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