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Can invasive thymomas be resected by video-assisted thoracoscopic surgery?
1National Cancer Center, 11 Hospital Drive, Singapore 169610, Singapore. agasthian@singnet.com.sg
Asian Cardiovascular & Thoracic Annals
|September 3, 2011
Summary
Video-assisted thoracic surgery can safely remove selected invasive thymomas using a modified technique. This approach avoids sternotomy and offers a minimally invasive option for these challenging tumors.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
Background:
- Video-assisted thoracic surgery (VATS) is established for early-stage thymomas.
- Its application in invasive thymomas is less defined due to concerns about tumor seeding and complete resection.
Purpose of the Study:
- To evaluate the safety and efficacy of a modified VATS technique for resecting selected invasive thymomas.
- To determine if VATS can achieve complete tumor removal without sternotomy in these cases.
Main Methods:
- A modified VATS thymomectomy was performed on 77 patients (1998-2009).
- Inclusion criteria: tumors <5 cm without major invasion on CT.
- A modified dissection technique prevented capsule breach; en bloc resection included adjacent structures if necessary.
Main Results:
- 13 invasive thymomas (Masaoka stage III/IV) were resected.
- Mean surgery duration: 138 min; mean hospital stay: 3.6 days.
- One local recurrence occurred during 4.9 years follow-up; no operative mortality.
Conclusions:
- Modified VATS allows safe resection of selected invasive thymomas.
- This technique can potentially avoid sternotomy for these challenging cases.
- Adjuvant radiotherapy was administered to all patients.
