[Surgery for mediastinal tumor; by video-assisted thoracoscopic thymo-thymomectomy with sternal lifting]

The successful key of video-assisted thoracoscopic surgery (VATS) for mediastinal tumor should be appropriate surgical approach according to the site of tumor and relationship between large vessels and tumor. We retrospectively reviewed VATS for mediastinal tumor for 2 years. Thirty-three patients underwent surgery for mediastinal tumor, 19 patients by VATS;12 thymo-thymomectomies (2 myastenia gravis with thymoma), 4 neurinomas, 3 cystic tumors. Thymoma is the most frequent mediastinal tumor and thymo-thymomectomy for thymoma and extended thymectomy for myasthenia gravis is usually recommended. Thymus is located in the narrow anterior mediastinum between sternum and heart. So that we use sternal lifting devices to get working space for video-assisted thoracoscopic thymo-thymomectomy. Our indication is thymic cyst, thymoma (noninvasive to surrounding organs, without dissemination, diameter less than 6 cm, and tolerable for one-lung ventilation), and myasthenia gravis. Video-assisted thoracoscopic thymo-thymomectomy using sternal lifting was performed for 12 patients among 19 thymic tumor patients and is considered to be a minimally invasive and safe operative procedure for selected thymoma patients.