| 摘要: |
| ［摘要］ 目的 探讨无管化胸腺瘤切除术后并发症的发生情况及其独立危险因素，为临床优化围手术期管理提供参考依据。方法 回顾性分析2021年1月至2025年7月在广西壮族自治区南溪山医院接受无管化胸腺瘤切除术治疗80例患者的临床资料。记录患者一般信息、手术相关指标及术后并发症情况。采用单因素分析筛选风险因素，并通过Firth校正的多因素logistic回归分析独立危险因素。结果 80例患者中，术后出现并发症11例，其中以心律失常和切口脂肪液化最为常见。单因素分析显示，肿瘤最大径、Masaoka-Koga分期、重症肌无力、手术方式、手术时间、术中出血量及人工气胸持续时间与并发症发生相关（P<0.05）。Firth校正的多因素logistic回归分析结果表明，较大的肿瘤最大径以及较长的手术时间和人工气胸持续时间是无管化胸腺瘤切除术后并发症发生的独立危险因素（P<0.05）。结论 无管化胸腺瘤切除术总体安全可行，但肿瘤最大径较大、手术时间和人工气胸持续时间较长的患者并发症风险较高。应针对高危患者加强术前评估及围手术期管理，以降低术后并发症发生率。 |
| 关键词: 无管化 胸腺瘤 胸腔镜 机器人辅助手术 重症肌无力 并发症 危险因素 |
| DOI：10.3969/j.issn.1674-3806.2025.10.06 |
| 分类号:R 736.3 |
| 基金项目:广西医疗卫生适宜技术开发与推广应用项目（编号：S2023031）；广西壮族自治区卫生健康委自筹经费科研课题（编号：Z-C20230196）；桂林市自筹经费科技项目（编号：20220121z） |
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| Analysis on the incidence and risk factors of complications after tubeless thymoma resection: a retrospective study of 80 cases |
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XU Yi, LU Ting, XU Ke, FENG Xiaoyan, XIONG Rongsheng
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Department of Thoracic Surgery, Nanxishan Hospital of Guangxi Zhuang Autonomous Region(the Second People′s Hospital of Guangxi Zhuang Autonomous Region), Guilin 541002, China
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| Abstract: |
| ［Abstract］ Objective To explore the incidence and independent risk factors of complications after tubeless thymoma resection, and to provide a reference basis for the clinical optimization of perioperative management. Methods A retrospective analysis was conducted on the clinical data of 80 patients who underwent tubeless thymoma resection in Nanxishan Hospital of Guangxi Zhuang Autonomous Region from January 2021 to July 2025. The patients′ general data, surgical-related indicators and postoperative complications were recorded. Univariate analysis was used to screen for the risk factors, and multivariate Firth-corrected logistic regression was used to analyze the independent risk factors. Results In the 80 patients, 11 patients had postoperative complications, among which arrhythmia and incision fat liquefaction were the most common. Univariate analysis showed that the maximum diameter of tumors, Masaoka-Koga stage, myasthenia gravis, surgical method, duration of operation, intraoperative blood loss and duration of artificial pneumothorax were associated with the occurrence of complications(P<0.05). The analysis results of multivariate Firth-corrected logistic regression indicated that the longer maximum diameter of tumors, longer duration of operation and longer duration of artificial pneumothorax were independent risk factors for the occurrence of postoperative complications after tubeless thymoma resection(P<0.05). Conclusion Tubeless thymoma resection is generally safe and feasible, but patients with longer maximum diameter of tumors, longer duration of operation and longer duration of artificial pneumothorax have a higher risk of complications. For the high-risk patients, preoperative assessment and perioperative management should be strengthened to reduce the incidence of postoperative complications. |
| Key words: Tubeless Thymoma Thoracoscope Robot-assisted surgery Myasthenia gravis Complications Risk factors |
