The Curative Effect of Extended Thymectomy Performed Through Subxiphoid-right VATS Approach With Elevation of Sternum
Thymoma, Myasthenia Gravis, Mediastinal Tumor
About this trial
This is an interventional treatment trial for Thymoma focused on measuring thymoma, thymectomy, Myasthenia Gravis, VATS, subxiphoid, elevation of the sternum, curative effect
Eligibility Criteria
Inclusion Criteria:
- MG with thymic hyperplasia, thymoma or other anterior mediastinum disease
- Masaoka stagingⅠ-Ⅱ
- Patients with normal cardio-pulmonary function before operation, BMI<30
Exclusion Criteria:
- Unable to tolerate surgery
- Masaoka staging Ⅲ-Ⅳ
- Patients who have undergone previous surgery or radiotherapy
- Myasthenia crisis
- Chronic pain or using opioid analgesics before surgery
- Preoperative mental disorders such as excessive anxiety
- Patients who underwent previous mediastinal surgery or cardiac surgery
- Patients with thoracic deformity
Sites / Locations
- The Second Affiliated Hospital of Hainan Medical UniversityRecruiting
- Shanghai Pulmonary HospitalRecruiting
- Shanxi Provincial Cancer HospitalRecruiting
- Shaoxing Center HospitalRecruiting
- Taizhou Center Hospital (Taizhou Unoversity Hospital)Recruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Subxiphoid approach
Intercostal approach
The patients in subxiphoid group will get subxiphoid approach extended thymectomy by VATS. Whole dissection was performed through a 4 to 7cm transverse subxiphoid incision, and a single 5-mm port was inserted into the right chest cavity for the video thoracoscope and subsequently for the chest tube. The sternum was elevated with two hooks connected to the sternal frame. The lower hook was inserted through the subxiphoid incision, and the superior hook was inserted percutaneously after the mediastinal tissue including the major mediastinal vessels was dissected from the inner surface of the sternum. The thymus and fatty tissue of the anterior mediastinum and the aorta-pulmonary window was completely removed.
The patients in intercostal group will get intercostal approach extended thymectomy by VATS.