title: Video-assisted thoracoscopic surgical thymectomy to treat early thymoma: a comparison with the conventional transsternal approach.
abstract: BACKGROUND
  For thymoma, the feasibility of resection via video-assisted thoracoscopic surgery (VATS) remains controversial. The objective of our study was to compare the outcomes of VATS and transsternal thymectomy in order to evaluate the efficacy of the VATS method for treatment of early stage thymoma.
  
  
  METHODS
  This study is a retrospective study of 120 patients who underwent thymectomy of early stage thymoma (Masaoka stage I and II) in a single medical center from 1991 to 2010. Of these patients, 76 patients underwent VATS thymectomy (VATS group) and 44 patients underwent the conventional transsternal approach (sternotomy group). We applied the Kaplan-Meier method to estimate overall survival (OS), recurrence-free survival (RFS), and time to tumor recurrence (TTR) of these two groups.
  
  
  RESULTS
  The mean follow-up time was 61.9 months in the VATS group and 69.7 months in the sternotomy group. There was no surgery-related mortality or major complication. The VATS group had smaller specimen size (p < 0.05) and tumor size (p < 0.01), shorter length of stay (LOS) in the hospital (p < 0.01), and shorter duration of chest tube drainage (p < 0.05) than the sternotomy group. There were no significant differences between the two groups for OS, RFS, and TTR.
  
  
  CONCLUSIONS
  In early stage thymoma, VATS thymectomy associated with shorter hospital LOS and shorter duration of pleural drainage compared with the conventional transsternal approach. Otherwise, the two approaches had similar oncologic outcomes during the mean 60-month follow-up period.
authors: Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
authors: Tom J
authors: TJ
authors: Liu
authors: Mong-Wei
authors: MW
authors: Lin
authors: Min-Shu
authors: MS
authors: Hsieh
authors: Ming-Wei
authors: MW
authors: Kao
authors: Ke-Cheng
authors: KC
authors: Chen
authors: Chin-Chih
authors: CC
authors: Chang
authors: Shuenn-Wen
authors: SW
authors: Kuo
authors: Pei-Ming
authors: PM
authors: Huang
authors: Hsao-Hsun
authors: HH
authors: Hsu
authors: Jin-Shing
authors: JS
authors: Chen
authors: Hong-Shiee
authors: HS
authors: Lai
authors: Jang-Ming
authors: JM
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D056346:Sternotomy; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted; D013906:Thoracoscopy; D013934:Thymectomy; D013945:Thymoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013953:Thymus Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D055815:Young Adult