Thymoma thoracotomy

The thymus is a very important immune organ in the body, and thymoma can occur due to various reasons. When thymoma is relatively small, the symptoms are not very obvious. As it grows slowly, the patient will experience chest pain, chest tightness, cough, and discomfort in the chest. Open chest surgery for thymoma is the most common way to treat this disease. As a patient, you can understand the surgery in detail.

treat

1. Treatment principles

Once a thymoma is diagnosed, it should be surgically removed. Whether benign or malignant, thymoma should be removed as soon as possible. For resected malignant thymoma, a pathological biopsy can be taken to guide postoperative treatment. For those with partial resection, postoperative radiotherapy can relieve symptoms and prolong patient survival.

2. Issues that should be noted during surgery

For isolated benign thymoma without adhesion, complete removal is not difficult and the operation can be completed smoothly. However, the difficulties must be fully estimated during surgery in some complex cases. Malignant thymoma must be explored first to clarify the relationship between the tumor and the surrounding adjacent organs before dissection. Thymoma is located at the bottom of the mediastinum, at the junction of the heart and large blood vessels; malignant thymoma adheres and infiltrates to the surrounding areas; when the tumor grows, adjacent tissues and organs are pushed away, and the normal anatomical relationship is changed; the fibrous connective tissue adheres and thickens, making it difficult to distinguish from the blood vessels, all of which can cause accidental injury to blood vessels during surgery and cause massive bleeding.

complication

1. Myasthenia gravis

Myasthenia gravis has long been associated with the thymus gland (or thymoma). Myasthenia gravis can be clinically divided into three types. Ptosis, long-term visual fatigue, and diplopia are ocular muscle type; inability to extend the upper limbs for a long time and the need to sit down and rest after walking a short distance are trunk type; difficulty chewing and swallowing, and even paralysis of the respiratory muscles are medullary type. The most dangerous clinical condition is myasthenic crisis, in which the patient's respiratory muscles are paralyzed and artificial breathing is required.

Myasthenia gravis is currently believed to be an autoimmune disease, mainly caused by mutation of the thymus due to certain stimulation. For many years, anti-acetylcholine esterase drugs such as pyridostigmine have been used to treat myasthenia gravis. In recent years, immunosuppressants such as hormones and cyclophosphamide have been added.

2. Simple red cell aplasia

One of the coexisting diseases with thymoma is pure red cell aplasia. Pure red cell aplasia can be primary with unclear causes, or it can be secondary to drugs, infection, and tumors.

3. Nephrotic syndrome nephritis

The relationship between nephrotic nephritis and thymoma is still unclear. Nephrotic syndrome may be part of the systemic presentation of certain tumors, such as Hodgkin disease. A possible explanation is that thymoma cross-reacts with the antigen-antibody complexes of glomerulonephritis.