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Modified Subxiphoid Thoracoscopic Thymectomy for Locally Invasive Thymoma
Jia-Hao Jiang1, Jian Gao1, Yi Zhang1
1Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
The Annals of Thoracic Surgery
|November 29, 2020
Summary
Modified subxiphoid thoracoscopic thymectomy is a safe and feasible minimally invasive approach for locally invasive thymomas. This technique, using an auxiliary sternal retractor, facilitates easier and safer thymectomy for select patients.
Area of Science:
- Thoracic surgery
- Surgical oncology
- Minimally invasive procedures
Background:
- Locally invasive thymomas present surgical challenges.
- Standard thymectomy approaches may have limitations for advanced disease.
Purpose of the Study:
- To evaluate the feasibility and safety of a modified subxiphoid thoracoscopic thymectomy.
- To assess this technique for patients with locally invasive thymomas (Masaoka stage III).
Main Methods:
- Modified subxiphoid thoracoscopic thymectomy with an auxiliary sternal retractor was performed on 48 patients.
- Procedures included resection of infiltrated structures like the pericardium, lung, or left innominate vein.
- No conversions to median sternotomy were required.
Main Results:
- The median tumor size was 5 cm (maximal 12 cm).
- Median blood loss was 50 mL, with a median chest tube duration of 3 days and hospital stay of 4.5 days.
- All patients recovered well with no serious perioperative complications; no local recurrence or distant metastasis was observed post-radiotherapy.
Conclusions:
- Modified subxiphoid thoracoscopic thymectomy with an auxiliary sternal retractor is a viable alternative.
- This approach enhances the ease and safety of minimally invasive thymectomy for selected patients with locally invasive thymomas.
