Simultaneous thoracoscopic resection for coexisting pulmonary and thymic lesions

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Management of synchronous thymic and pulmonary lesions is challenging.
• Lack of established surgical guidelines for these coexisting diseases.
• Retrospective review of preliminary experience with simultaneous resection.

Purpose of the Study:

• To evaluate the safety and feasibility of simultaneous thoracoscopic resection for coexisting lung and thymus lesions.
• To report preliminary outcomes and surgical experience.

Main Methods:

• Retrospective review of nine patients undergoing simultaneous thoracoscopic resection (August 2008 - November 2013).
• Procedures included thoracoscopic lobectomy, bronchovascular sleeve lobectomy, pulmonary wedge resection, thymectomy, and thymic cyst resection.
• Analysis of patient demographics, preoperative assessment, surgical procedures, and postoperative course.

Main Results:

• Nine patients (4 female, 5 male; median age 64) with thymic neoplasm and solitary pulmonary lesion.
• Procedures varied: lobectomy/thymectomy, sleeve lobectomy/thymic cyst resection, wedge resection/thymectomy or thymic cyst resection.
• Median operative time 110 minutes, median blood loss 120 mL; two patients had postoperative pneumonia, no mortality.
• Two patients died from metastatic lung cancer 14 months post-surgery.

Conclusions:

• Simultaneous thoracoscopic resection of coexisting pulmonary and thymic lesions is safe and feasible.
• This approach is suitable for selected patients with synchronous lung and thymus diseases.
• Further studies are warranted to establish definitive surgical guidelines.