外科决策：胸腺瘤和重症肌无力

大约15%的重症肌无力患者受到胸腺瘤的影响。精确的肿瘤分期对于计划适当的手术是必要的。在早期阶段，完全手术切除是主要的治疗方法。微创入路可以由训练有素的外科医生安全地进行，并且可能是肌无力患者的首选，因为它们可以从肿瘤学、神经系统和外科的角度确保最佳结果，避免开放入路的并发症。对于肌无力患者的晚期胸腺瘤，必须对治疗方法进行仔细的多学科规划，特别是对涉及肺和大血管的扩大切除。

About 15% of patients with myasthenia gravis are affected by thymoma. Precise tumor staging is necessary to plan the appropriate operation. In early stages, complete surgical resection is the mainstay of treatment. Minimally invasive approaches can be safely performed by highly trained surgeons, and may be preferred in myasthenic patients because they can ensure optimal results from the oncological, neurologic, and surgical point of views, avoiding the complications of open approach. For advanced stage thymoma in myasthenic patients, a careful, multidisciplinary planning of the therapeutic approach must be undertaken, particularly for extended resections involving the lung and great vessels.

Keywords:Mediastinum; Myasthenia gravis; Surgery; Thymoma; Thymus.

Comacchio GM, Marulli G, Mammana M, Natale G, Schiavon M, Rea F. Surgical Decision Making: Thymoma and Myasthenia Gravis. Thorac Surg Clin. 2019 May;29(2):203-213. doi: 10.1016/j.thorsurg.2018.12.007. Epub 2019 Mar 7. PMID: 30928002.