What is the role of VATS in the treatment of thymoma?

Updated: Jul 27, 2020
  • Author: Kendrix J Evans, MD, MS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

With the advent of video-assisted minimally invasive surgery, many of the traditional thoracic procedures have been abandoned. Cases of video-assisted thoracoscopic surgery (VATS) have been described; however, there is a need for additional long-term data.

Roviaro et al performed video thoracoscopy on six patients with thymomas; however, they did not describe the extent of resection, the size of the tumor, or the tumor stage, and long-term follow-up data are unavailable. [15] Kaiser advocated the use of transcervical dissection in conjunction with video thoracoscopy, allowing better exposure. [16]

Mack presented a series of photographs of thymus glands removed by means of thoracoscopy. [17] These photographs confirmed that the thymus gland can be resected completely by experienced surgeons. Long-term follow-up data are required to determine the true efficacy of this procedure in comparison with traditional thymectomy.

In a study of 140 patients with stage I and II thymoma, Chao et al compared perioperative and oncologic outcomes after VATS resection for stage I and II thymoma with those obtained after median sternotomy. [18] No operative deaths occurred, and there were no statistically significant differences in 5-year survival between the two study groups. VATS was associated with better perioperative outcomes (eg, less intraoperative blood loss, greater frequency of extubation in the operating room after surgery, and a shorter length of stay).


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