Surgical approaches for thymectomy: a narrative review

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Neuromuscular Disorders

Background:

• Thymectomy is a standard treatment for thymic neoplasms and myasthenia gravis.
• The number of thymectomies has significantly increased, with notable growth in minimally invasive procedures.
• Surgical approaches have evolved from open to diverse minimally invasive techniques.

Purpose of the Study:

• To provide a narrative overview of thymectomy approaches.
• To describe indications, preoperative considerations, and operative techniques.
• To summarize the pros and cons of each thymectomy method.

Main Methods:

• A comprehensive literature search was performed using MEDLINE and Google Scholar.
• Included original articles, meta-analyses, reviews, and case reports up to July 2024.
• Focused on original full-length articles, meta-analyses, review articles, and case reports.

Main Results:

• Complete surgical resection is crucial for reducing recurrence in thymic malignancies.
• Factors related to the tumor, patient, and surgeon influence the choice of thymectomy technique.
• Both trans-sternal and minimally invasive thymectomy rates have increased.

Conclusions:

• There is no universally agreed-upon best surgical technique for thymectomy.
• Each thymectomy approach has distinct advantages and disadvantages.
• Thorough preoperative evaluation is essential for optimizing patient prognosis and surgical outcomes.