Unilateral thoracoscopic subtotal thymectomy for the treatment of stage I and II thymoma

Abstract

Objective: The purpose of this study was to determine the feasibility of thoracoscopic thymectomy for the treatment of Masaoka stage I and II thymoma.

Methods: We evaluated the short-term outcomes of 40 patients undergoing surgery for Masaoka stage I and II thymomas without myasthenia gravis between July 2000 and July 2008. Of these, 22 patients underwent complete thymoma resection using unilateral thoracoscopic subtotal thymectomy (UTST group), and 18 patients underwent trans-sternal thymectomy (TST group).

Results: Intra-operative blood loss amounts did not differ significantly between the UTST and TST groups (100.6 ml and 208.1 ml, respectively, p=0.0513). The duration of the postoperative hospital stay was significantly shortened in the UTST group (4.6 days vs 11.2 days, p<0.0001). No patient in the UTST group underwent conversion to open surgery. No severe surgical complications, such as bleeding due to injury to the left brachiocephalic vein, and no postoperative complications, were detected in this series.

Conclusions: These preliminary results suggest that thoracoscopic thymectomy for Masaoka stage I and II thymoma is technically feasible and safe, and it is less invasive for the patient. Nevertheless, this procedure requires further investigation in a large series with a longer follow-up.