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Review
. 2015 Nov;4(6):495-508.
doi: 10.3978/j.issn.2225-319X.2015.08.01.

Video-assisted thoracoscopic surgery versus open thymectomy for thymoma: a systematic review

Ashleigh Xie  1 , Richard Tjahjono  1 , Kevin Phan  1 , Tristan D Yan  1
Affiliations
Review

Video-assisted thoracoscopic surgery versus open thymectomy for thymoma: a systematic review

Ashleigh Xie et al. Ann Cardiothorac Surg. 2015 Nov.

Abstract

Background: Video-assisted thoracoscopic surgery (VATS) thymectomy is an increasingly utilized alternative to traditional open approaches for the resection of thymomas. Recent studies have suggested comparable survival and oncological efficacy as well as reduced perioperative morbidity when using the VATS approach. This current systematic review thus aimed to critically evaluate existing evidence for the efficacy and safety of VATS versus open (transsternal or transthoracic) thymectomy for thymomas.

Methods: Six electronic databases were searched from their date of inception to April 2015. Relevant studies were identified using specific eligibility criteria and data were extracted and analyzed based on predefined primary and secondary endpoints.

Results: Fourteen comparative observational studies with a total of 1,061 patients were obtained for qualitative assessment, data extraction and analysis. Five-year overall survival and 10-year recurrence-free survival was similar or higher in patients undergoing VATS compared to open thymectomy. On average, the VATS group also demonstrated reduced intraoperative blood loss (131.8 vs. 340.5 mL), shorter hospital stays (7.0 vs. 9.8 days), and lower rates of postoperative pneumonia (1.9% vs. 4.1%). The mean rate of conversion from VATS to open thymectomy was relatively low (3.1%), while 30-day mortality remained low in both the VATS and open groups (0 vs. 0.3%).

Conclusions: The current evidence suggests that VATS thymectomy for thymoma has at least equal if not superior oncological efficacy and survival outcomes, as well as reduced perioperative complications, compared to open surgery. Further adequately powered studies and future randomized trials are required to confirm these findings.

Keywords: Video-assisted thoracoscopic surgery (VATS); thymectomy; thymoma.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure S1
Figure S1
Search strategy for systematic review on video-assisted thoracoscopic surgery versus open thymectomy for thymoma.
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References

    1. Davenport E, Malthaner RA. The role of surgery in the management of thymoma: a systematic review. Ann Thorac Surg 2008;86:673-84. - PubMed
    1. Zahid I, Sharif S, Routledge T, et al. Video-assisted thoracoscopic surgery or transsternal thymectomy in the treatment of myasthenia gravis? Interact Cardiovasc Thorac Surg 2011;12:40-6. - PubMed
    1. Kondo K. Therapy for thymic epithelial tumors. Gen Thorac Cardiovasc Surg 2014;62:468-74. - PubMed
    1. Ng CS, Wan IY, Yim AP. Video-assisted thoracic surgery thymectomy: the better approach. Ann Thorac Surg 2010;89:S2135-41. - PubMed
    1. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 2010;8:336-41. - PubMed