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Abstract
Aim: The advantages and feasibility of video-assisted thoracoscopic surgery (VATS) in the surgical management of early resectable thymoma and thymic hyperplasia have largely been described and adopted in many thoracic surgery units. In order to allow for resection of all immunogenic thymic cells in patients with myasthenia gravis, surgical removal of the whole thymus gland including perithymic and pericardiophrenic fatty tissue becomes imperative. It is also important to achieve radical resection and excision in cases of thymoma.
Methods: Numerous technical variations of VATS thymectomy have been reported in literature. In this study, the surgical technique of a minimally invasive, extended thymectomy through a bilateral approach is illustrated with key features highlighted.
Results: In our experience, no conversion to the open transternal approach, surgical mortality or major complications were observed; the median length of hospital stay was 3 days.
Conclusion: Bilateral video-assisted extended thymectomy is an effective, safe and well-tolerated approach, with surgical benefits and clinical outcomes similar to other thoracoscopic techniques.
Keywords
Thymoma
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video-assisted thoracic technique
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thymectomy
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bilateral video-assisted thoracoscopic surgery
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Jury Brandolini.
Video-assisted thoracoscopic thymectomy: bilateral approach.
Mini-invasive Surgery, 2020, 4(1): 45 DOI:10.20517/2574-1225.2020.27
| [1] |
Okumura M,Tateyama H,Matsumura A.The World Health Organization histologic classification system reflects the oncologic behavior of thymoma: a clinical study of 273 patients..Cancer2010;94:624-32
|
| [2] |
Coosemans W,Van Raemdonck DE.Thoracoscopic surgery: the Belgian experience..Ann Thorac Surg1993;56:721-30
|
| [3] |
Rückert JC,Müller JM.Operative technique for thoracoscopic thymectomy..Surg Endosc1999;13:943-6
|
| [4] |
Lee CY,Lee JG,Bae MK.Bilateral video-assisted thoracoscopic thymectomy as a surgical extended thymectomy with more favorable early surgical outcomes for myasthenia gravis patients..Surg Endosc2011;25:849-54
|
| [5] |
Bromberger B.Bilateral VATS thymectomy in the treatment if myasthenia gravis..Video Assist Thorac Surg2017;2:12Available from: https://vats.amegroups.org/article/view/3723.[Last accessed on 18 Jul 2020]
|
| [6] |
Chang PC,Kao EL,Chang HY.Bilateral video-assisted thoracoscopic thymectomy vs. extended transsternal thymectomy in myasthenia gravis: a prospective study..Eur Surg Res2005;37:199-203
|
| [7] |
Shigemura N,Inoue N,Ohta M.Inclusion of the transcervical approach in video-assisted thoracoscopic extended thymectomy (VATET) for myasthenia gravis: a prospective trial..Surg Endosc2006;20:1614-8
|
| [8] |
Lee CY,Lee JG,Bae MK.Bilateral video-assisted thoracoscopic thymectomy has a surgical extent similar to that of transsternal extended thymectomy with more favorable early surgical outcomes for myasthenia gravis patients..Surg Endosc2011;25:849-54
|
| [9] |
Siwachat S,Lapisaterpun W,Taioli E.Comparative clinical outcomes after thymectomy for myasthenia gravis: thoracoscopic versus transternal approach..Asian J Surg2018;41:77-85
|
| [10] |
Gung Y,Li S.Sternotomy versus video-assisted thoracoscopic surgery for thymectomy of myasthenia gravis patients: a meta-analysis..Asian J Endosc Surg2016;9:285-94
|
| [11] |
Kido T,Inoue Y,Takao T.Resection of anterior mediastinal masses through an infrasternal approach..Ann Thorac Surg1999;67:263-5
|
| [12] |
Suda T,Tochii D,Tochii S.Video-assisted thoracoscopic thymectomy versus subxiphoid single-port thymectomy: initial results..Eur J Cardiothorac Surg2016;49:i54-8
|
| [13] |
Toker A,Zielinski M,Tomulescu V.Standard terms, definitions, and policies for minimally invasive resection of thymoma..J Thorac Oncol2011;6:S1739-42
|
| [14] |
Girard N,Van Houtte P,van Shil P.Thymoma: a focus on current therapeutic management..J Thorac Oncol2009;4:119-26
|
| [15] |
Kneuertz J,Stiles BM,Rahouma M.Robotic thymectomy is feasible for large thymomas: a propensity-matched comparison..Ann Thorac Surg2017;104:1673-8
|