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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">grekov</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник хирургии имени И.И. Грекова</journal-title><trans-title-group xml:lang="en"><trans-title>Grekov's Bulletin of Surgery</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0042-4625</issn><issn pub-type="epub">2686-7370</issn><publisher><publisher-name>Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.24884/0042-4625-2019-178-5-103-106</article-id><article-id custom-type="elpub" pub-id-type="custom">grekov-1255</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НАБЛЮДЕНИЯ ИЗ ПРАКТИКИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>OBSERVATION FROM PRACTICE</subject></subj-group></article-categories><title-group><article-title>СЛУЧАЙ ТИМОМТИМЭКТОМИИ ИЗ КОМБИНИРОВАННОГО ДОСТУПА</article-title><trans-title-group xml:lang="en"><trans-title>THE CLINICAL CASE OF THYMECTOMY USING COMBINED APPROACHES</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дзидзава</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Dzidzava</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дзидзава Илья Игоревич - д-р мед. наук, доцент, начальник кафедры госпитальной хирургии, полковник медицинской службы</p></bio><bio xml:lang="en"><p>Il’ya I. Dzidzava</p></bio><email xlink:type="simple">dzidzava@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дмитроченко</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Dmitrochenko</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дмитроченко Иван Валерьевич - старший ординатор отделения торакальной хирургии кафедры госпитальной хирургии, капитан медицинской службы</p></bio><bio xml:lang="en"><p>Ivan V. Dmitrochenko</p></bio><email xlink:type="simple">dmitrochenkoiv@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Фуфаев</surname><given-names>Е. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Fufaev</surname><given-names>E. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Фуфаев Евгений Евгеньевич - канд. мед. наук, доцент кафедры госпитальной хирургии, подполковник медицинской службы</p></bio><bio xml:lang="en"><p>Evgeniy E. Fufaev</p></bio><email xlink:type="simple">djekk77@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Котив</surname><given-names>Б. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Kotiv</surname><given-names>B. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Котив Богдан Николаевич - д-р мед. наук, профессор, заместитель начальника академии по учебной и научной работе, заслуженный врач РФ, генерал-майор медицинской службы</p></bio><bio xml:lang="en"><p>Bogdan N. Kotiv</p></bio><email xlink:type="simple">kotivbn@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баринов</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Barinov</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Баринов Олег Владимирович - д-р мед. наук, заместитель начальника кафедры госпитальной хирургии, полковник медицинской службы</p></bio><bio xml:lang="en"><p>Oleg V. Barinov</p></bio><email xlink:type="simple">barinov_o@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ясюченя</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Yasyuchenya</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ясюченя Денис Александрович - канд. мед. наук, начальник отделения торакальной хирургии кафедры госпитальной хирургии, подполковник медицинской службы</p></bio><bio xml:lang="en"><p>Denis A. Yasyuchenya</p></bio><email xlink:type="simple">fsurgeonf@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бардаков</surname><given-names>С. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Bardakov</surname><given-names>S. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бардаков Сергей Николаевич - канд. мед. наук, преподаватель кафедры госпитальной хирургии, капитан медицинской службы</p></bio><bio xml:lang="en"><p>Sergey N. Bardakov</p></bio><email xlink:type="simple">bard@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Попов</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Popov</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Попов Владимир Анатольевич - старший ординатор отделения торакальной хирургии кафедры госпитальной хирургии, капитан медицинской службы</p></bio><bio xml:lang="en"><p>Vladimir A. Popov</p></bio><email xlink:type="simple">v.a.popov@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зубарев</surname><given-names>П. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Zubarev</surname><given-names>P. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зубарев Петр Николаевич - д-р мед. наук, профессор кафедры общей хирургии</p></bio><bio xml:lang="en"><p>Petr N. Zubarev</p></bio><email xlink:type="simple">zubarev_pn@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Коваленко</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kovalenko</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Коваленко Владислав Владимирович - клинический ординатор кафедры госпитальной хирургии, лейтенант медицинской службы</p></bio><bio xml:lang="en"><p>Vlad V. Kovalenko</p></bio><email xlink:type="simple">kollmar7@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное военное образовательное учреждение высшего образования «Военно-медицинская академия имени С. М. Кирова» Министерства обороны Российской Федерации</institution></aff><aff xml:lang="en"><institution>Military Medical Academy named after S. M. Kirov</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>18</day><month>09</month><year>2019</year></pub-date><volume>178</volume><issue>5</issue><fpage>103</fpage><lpage>106</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Дзидзава И.И., Дмитроченко И.В., Фуфаев Е.Е., Котив Б.Н., Баринов О.В., Ясюченя Д.А., Бардаков С.Н., Попов В.А., Зубарев П.Н., Коваленко В.В., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Дзидзава И.И., Дмитроченко И.В., Фуфаев Е.Е., Котив Б.Н., Баринов О.В., Ясюченя Д.А., Бардаков С.Н., Попов В.А., Зубарев П.Н., Коваленко В.В.</copyright-holder><copyright-holder xml:lang="en">Dzidzava I.I., Dmitrochenko I.V., Fufaev E.E., Kotiv B.N., Barinov O.V., Yasyuchenya D.A., Bardakov S.N., Popov V.A., Zubarev P.N., Kovalenko V.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.vestnik-grekova.ru/jour/article/view/1255">https://www.vestnik-grekova.ru/jour/article/view/1255</self-uri><abstract><p>Для удаления тимуса предложены различные хирургические доступы. При этом к выбору хирургического доступа у каждого больного следует подходить дифференцированно. Представляем клинический случай удаления опухоли вилочковой железы из комбинированного (субксифоидального и трансторакального) хирургического доступа.</p></abstract><trans-abstract xml:lang="en"><p>Various surgical approaches was proposed to remove the thymus. At the same time, the choice of surgical approach in each patient should have been differential. We presented the clinical case of the removal of thymus tumor using combined (subxyphoid and transthoracic) surgical approach.</p><p>The authors declare no conflict of interest.</p><p>The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>видеоассистированная тимэктомия</kwd><kwd>субксифоидальный доступ</kwd><kwd>тимома</kwd><kwd>тимэктомия</kwd><kwd>миастения</kwd></kwd-group><kwd-group xml:lang="en"><kwd>video-assisted thymectomy</kwd><kwd>subxyphoid approach</kwd><kwd>thymoma</kwd><kwd>thymectomy</kwd><kwd>myasthenia</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Marulli G., Comacchio G. M., Rea F. Robotic thymectomy // J. of Visualiz. Surg. 2017. № 3. P. 68–75.</mixed-citation><mixed-citation xml:lang="en">Marulli G., Comacchio G. M., Rea F. Robotic thymectomy. J. of Visualiz. Surg. 2017;(3):68–75.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Marulli G., Maessen J., Melfi F. et al. 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