title: L-shaped mini-sternotomy combined with videoscopic approach for thymoma with invasion of major veins.
abstract: It might be possible to remove thymic tumors with minimal invasion of the left brachiocephalic vein (BCV) using an advanced videoscopic technique; simple resection of this vessel can be achieved via such an approach. However, tumor invasion of the superior vena cava or right  BCV requires angioplasty or reconstruction, both of which are difficult to perform in videoscopic procedures. We report a case of invasive thymoma with localized invasion of the great vessels at the junction of the left BCV and superior vena cava. An L-shaped mini-sternotomy combined with a videoscopic approach allowed thymectomy with safe vesselplasty of the involved vessels.
authors.affiliation: Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan asuga@is.icc.u-tokai.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suga
authors.affiliation: Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Takeichi
authors.affiliation: Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Iwazaki