title: Thoracoscopic thymectomy in children: our preliminary experience.
abstract: BACKGROUND
  The aim of this study is to present a preliminary series of six children affected by an anterior mediastinal mass, resulting in a thymoma. We treated this pediatric population by a video-assisted thoracoscopic thymectomy.
  
  
  METHODS
  We performed a retrospective study from January 2000 to January 2012 of all children affected by an anterior mediastinal mass, resulting in a thymoma. Data included sex, age at surgery, clinical and radiological features, surgical procedure, follow-up, and complications.
  
  
  RESULTS
  Video-assisted thoracoscopic thymectomy was performed in six children (five boys and one girl). Four patients presented with dyspnea and/or thoracic pain treated with analgesic and corticosteroid therapy without any benefits. Two patients were asymptomatic. Preoperatively, exams included radiological imaging, blood, and immunological test. All 6 patients were treated with a thoracoscopic approach; of these patients, 5 were treated with a thoracoscopic right-side thymectomy and 1 with a left-side approach. Patients were treated by a three-trocar technique, and thymectomy was performed using Valleylab (now Covidien) (Boulder, CO) LigaSure™. The mean operative time was 120 minutes. The mean hospital stay was 5 days. In all cases histological findings revealed no malignancy. The mean follow-up was 38 months.
  
  
  CONCLUSIONS
  Thoracoscopic thymectomy facilitated the goal of early thymectomy. The right-side approach is preferred because it gains a good visualization of the venous anatomy for dissection. The left side allows a good extended resection of both the thymus and perithymic fat. Thoracoscopic thymectomy should be consider a valid, less invasive alternative to the most radical open approach.
authors.affiliation: Division of Pediatric Surgery, Department of Medical Sciences, Surgery, and Neuroscience, University of Siena, Siena, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Molinaro
authors.forename: Alfredo
authors.initials: A
authors.lastname: Garzi
authors.forename: Elisa
authors.initials: E
authors.lastname: Cerchia
authors.forename: Rossella
authors.initials: R
authors.lastname: Angotti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Maggio
authors.forename: Jean S
authors.initials: JS
authors.lastname: Valla
authors.forename: Mario
authors.initials: M
authors.lastname: Messina
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D013934:Thymectomy / Q000379:methods*; D013945:Thymoma / Q000601:surgery*; D013953:Thymus Neoplasms / Q000601:surgery*