2005 Volume 19 Issue 4 Pages 557-561
During the past five years, 21 patients with thymoma have been treated by endoscopic surgical procedures in our department (infrasternal approach: 17, unilateral video-assisted thoracic surgery (VATS): 4). All tumors were preoperatively diagnosed as non-invasive thymomas, although pleuropericardial dissemination was revealed in 1 case at the time of surgery (stage I: 16, stage II: 4, stage IVa: 1). Extended thymectomy by infrasternal approach was performed for 17 cases, including 11 cases complicated by myasthenia gravis, while subtotal or partial thymectomy was performed for 4 cases by VATS. Infrasternal approach was converted to sternotomy in 2 cases, based on intraoperative findings on the clinical stage (including a case with dissemination), and complicating injury of the thymic vein in 1 case. The mean operation time and intraoperative bleeding were 213minutes and 129ml, respectively, in the cases treated by infrasternal approach, and 178minutes and 233ml, respectively, in the cases by VATS. Resection of thymoma was macroscopically complete, and neither prolonged hospital stay nor evidence of recurrence was detected in all cases. Our results suggest that endoscopic surgery for extirpation of non-invasive thymoma is acceptable as an appropriate surgical approach. Surgeons should improve the safety, reliability, and cost-effectiveness of endoscopic surgical procedures for patients with thymoma, and should employ the best procedure for each case.
