Thoracoscopic versus transsternal resection for early stage thymoma: long-term outcomes.
OBJECTIVE
This study was undertaken to investigate the efficacy of a video-assisted thoracoscopic (VATS) approach for stage I and II thymoma through comparisons with the transsternal approach.


METHODS
The indications for VATS resection were clinical stage I or II thymoma, a tumor less than 50 mm, located within the thymic lobes and separated from the brachiocephalic vein. Data were collected between 1995 and 2007.


RESULTS
Twenty-seven patients underwent total thymectomy (15 by VATS and 12 by the transsternal approach). The mean tumor size was 36.3 (22-50) mm for VATS and 37.6 (15-55) mm for the transsternal group (p = 0.7862). The mean lengths of the operation were 249.8 min and 227.9 min (p = 0.2728), respectively. The mean intraoperative blood loss was significantly lower in VATS, at 92.3 ml, than the 225.1 ml lost in the transsternal group (p = 0.0020). The morbidity rates were 13.3 and 8.3% (p = 0.6812), respectively. There was no mortality in either group. The mean follow-up periods were 109.0 (37-145) months following VATS and 102.0 (44-175) months following the transsternal approach. One stage II patient developed pleural dissemination three years after VATS resection. Other patients survived with no recurrence.


CONCLUSIONS
VATS resection of early stage thymoma can be performed with less bleeding and with a comparable prognosis to the transsternal approach. VATS resection should thus be considered as a viable option for treatment.
Division of Surgical Oncology, Department of Translational Medical Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan, tomtgw@nagasaki-u.ac.jp.
Tsutomu
T
Tagawa
Naoya
N
Yamasaki
Tomoshi
T
Tsuchiya
Takuro
T
Miyazaki
Shigeyuki
S
Morino
Shinji
S
Akamine
Takeshi
T
Nagayasu
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013249:Sternum / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D013934:Thymectomy / Q000379:methods*; D013945:Thymoma / Q000473:pathology* / Q000601:surgery*; D013950:Thymus Gland / Q000473:pathology* / Q000601:surgery*; D013953:Thymus Neoplasms / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome