评估多通道单孔腔镜穿刺器在机器人胸腔镜胸腺扩大切除术中的临床效果，探讨其应用优势。

回顾性分析江西省人民医院2021年6月至2025年2月行剑突下入路机器人胸腔镜胸腺扩大切除术的45例重症肌无力患者的临床资料，根据手术方式的不同分为两组，其中23例患者术中使用多通道单孔腔镜穿刺器（设为实验组），另22例正常使用机器人腔镜套管（设为对照组），观察对比两组患者手术基本情况及术后恢复情况。

45例患者均顺利完成手术，无中转开胸，术后均好转出院。术前临床资料对比差异均无统计学意义。实验组与对照组相比，手术时间[（158.26±60.51）min比（207.27±84.07）min]、术中切除淋巴结数量[（7.30±5.63）个比（1.91±3.85）个]及术后血气分析CO₂值[（38.66±5.09） mmol/L比（42.69±5.39） mmol/L]差异具有统计学意义（P<0.05）。而在术中出血量、术后24 h胸腔引流量、术后引流管留置时间、术后使用止痛药物时间等指标，两组差异无统计学意义。

在机器人胸腔镜剑突下入路行胸腺扩大切除术中，应用多通道单孔腔镜穿刺器可以更好地暴露手术视野，缩短手术时间，增加廓清纵隔特别是颈深区脂肪范围，并减少术后CO₂的潴留，术后并不增加疼痛时间，且操作简便、价格低廉，值得推广。

To compare and evaluate the clinical effect of multi-channel single-hole laparoscopic puncture device in da-Vinci robot-assisted thoracoscopic extended thymectomy, and to discuss its application advantages.

We performed a retrospective review of 45 myasthenia gravies patients who had da-Vinci robot-assisted thoracoscopic extended thymectomy at the Jiangxi Province General Hospital between June 2021 and February 2025. Patients were divided into experimental groups and control group according to surgical approaches. There were 23 patients in the experimental group (using the multi-channel single-hole laparoscopic puncture device duration operation), and the other 22 patients who used the normal robotic endoscopic cannula were treated as the control group. The basic operation conditions and postoperative recovery data were observed and compared.

All the 45 patients successfully completed the surgery and recovered, with no case changed to thoracotomy. There were no statistically significant differences in preoperative clinical data. Compared the experimental group with the control group, the differences in the operation duration [ (158.26±60.51) min vs (207.27±84.07) min], the number of lymph nodes removed during surgery was [ (7.30±5.63) vs (1.91±3.85) ], value of CO₂ by postoperative artery blood gas analysis [ (38.66±5.09) mmol/L vs (42.69±5.39) mmol/L] were statistically significant (P<0.05). There were no statistically significant differences between the two groups in terms of intraoperation bleeding volume, postoperative 24 h chest drainage volume, indwelling time of the thoracic drainage tube, and duration of anodyne use.

Using multi-channel single-hole laparoscopic puncture device in da-Vinci robot-assisted thoracoscopic extended thymectomy can better expose the surgical field, thereby shortening the surgical time. In addition, this application can increase the extent of clearing mediastinum adipose tissue, especially around the deep cervical area, and reduce the postoperative CO₂ retention, without increasing the duration of postoperative pain. The application is simple to handle and inexpensive, which is worth promoting.