title: It is feasible to operate on pathological Masaoka stage I and II thymoma patients with video-assisted thoracoscopy: analysis of factors for a successful resection.
abstract: BACKGROUND
  The objectives of this study were to evaluate the feasibility of video-assisted thoracoscopic (VATS) thymoma resection and to analyze the factors contributing to a successful perioperative period.
  
  
  METHODS
  Fifty-one patients with thymoma underwent VATS with the aim of thymoma resection. Four patients underwent minithoracotomy [due to technical difficulties, including small chest cavity, high body mass index (BMI), and disintegration of the capsule] and three patients underwent sternotomy (due to invasion of major vascular structures). The seven open-converted patients and seven other patients who underwent complete VATS thymoma resection but experienced prolonged hospital stay (≥7 days) formed Group B (n = 14), namely, the unsuccessful group, while successful VATS thymoma resection patients formed Group A (n = 37). The groups were compared with each other in terms of the characteristics of patients, tumors, and perioperative period.
  
  
  RESULTS
  Patients' characteristics, tumor size, WHO histologic type, and complications were similar in both Groups A and B (p > 0.05). Patients with Masaoka stage I and II thymomas were significantly more frequent in Group A (p < 0.01). Tumor size was a statistically insignificant variable for the determination of a successful VATS thymoma resection (p = 0.3). Masaoka stage and the size of the thymoma did not have any correlation with each other (p > 0.05).
  
  
  CONCLUSIONS
  The size of the thymoma was not observed to be correlated with Masaoka stage and it was not noted to be an important factor in successful VATS thymoma resection. A higher Masaoka stage (III and IVa) was found to be the only variable that predicted unsuccessful situations. Thus, Masaoka stage, rather than the size of the thymoma, should be the main concern for the surgeon.
authors.affiliation: Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey. atoker@istanbul.edu.tr
authors.forename: Alper
authors.initials: A
authors.lastname: Toker
authors.forename: Suat
authors.initials: S
authors.lastname: Erus
authors.forename: Sedat
authors.initials: S
authors.lastname: Ziyade
authors.forename: Berker
authors.initials: B
authors.lastname: Ozkan
authors.forename: Serhan
authors.initials: S
authors.lastname: Tanju
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000209:etiology; D009367:Neoplasm Staging; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D056346:Sternotomy / Q000706:statistics & numerical data; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods / Q000706:statistics & numerical data; D013908:Thoracotomy / Q000706:statistics & numerical data; D013945:Thymoma / Q000150:complications / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D013953:Thymus Neoplasms / Q000150:complications / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult