Comparison of surgical techniques for early-stage thymoma: Feasibility of minimally invasive thymectomy and comparison with open resection

Pennathur, Arjun; Qureshi, Irfan; Schuchert, Matthew J.; Dhupar, Rajeev; Ferson, Peter F.; Gooding, William E.; Christie, Neil A.; Gilbert, Sébastien; Shende, Manisha; Awais, Omar; Greenberger, Joel S.; Landreneau, Rodney J.; Luketich, James D.

doi:10.1016/j.jtcvs.2010.09.003

Cited by 139 publications

(97 citation statements)

References 28 publications

(35 reference statements)

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“…The mean hospital stay in this study was 4.0 days compared to 4.3 days in our study. As for the comparisons between the VATS group and MS group, our data were also consistent with published studies (18)(19)(20).…”

Section: Discussionsupporting

confidence: 91%

“…It has been reported that for the treatment of stage I and II thymomas, there were no significant differences in the 5-year survival, 5-year recurrence-free survival (19), or mean survival time (4) between the VATS group and open surgery group. In addition, robots have more technical advantages with three-dimensional vision systems and multi-articulated instruments, which allows an open-like intervention, while robotic extended thymectomy has been shown to be feasible and safe (22,23).…”

Section: Discussionmentioning

confidence: 92%

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A comparison of three approaches for the treatment of early-stage thymomas: robot-assisted thoracic surgery, video-assisted thoracic surgery, and median sternotomy

et al. 2017

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Background: This aim of this study was to compare three approaches of extended thymectomy for the treatment of early-stage thymomas, which included robot-assisted thoracic surgery (RATS), video-assisted thoracic surgery (VATS), and median sternotomy (MS) perioperative parameters. Results: A series of intra-and post-operative parameters showed significant differences in intra-operative blood loss volume, mean post-operative pleural drainage duration, pleural drainage volume and mean duration of hospital stay. For these parameters, during further analysis, significant differences were also demonstrated for comparisons between any two groups. RATS reduces the post-operative drainage duration and volume (2.88 vs. 3.77 and 4.41 days, P<0.05; 352.2 vs. 613.9 and 980 mL, P<0.05) and the hospital stay versus the MS and VATS groups (4.3 vs. 5.5 and 6.6 days). Three patients experienced post-operative complications in the MS group, and no post-operative complications occurred in the RATS or VATS group.Conclusions: RATS and VATS both appear feasible and safe for the resection of early-stage thymomas as compared to MS. RATS is less invasive than VATS with a shorter post-operative pleural drainage duration time, a reduced drainage volume, and a shorter hospital stay.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 92%

A comparison of three approaches for the treatment of early-stage thymomas: robot-assisted thoracic surgery, video-assisted thoracic surgery, and median sternotomy

et al. 2017

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“…Thymectomy done for early-stage (stages I and II) TETs ( Figure 2) through minimally invasive approaches also appears to be both feasible and safe (13)(14)(15)(16). Proponents of this strategy argue that such approaches are associated with less operative trauma and chest wall disruption, reduction in pulmonary or other morbidities, reduction in postoperative pain, and shorter length of stay.…”

Section: Controversies In Surgical Managementmentioning

confidence: 99%

Video-assisted and minimally-invasive open chest surgery for the treatment of mediastinal tumors and masses

Rakovich

Deslauriers

2017

J. Vis. Surg.

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“…Also, increased use of CT screening for lung cancer has led to more cases of incidentally detected small lesions at early stage. And advent of minimally invasive surgery in recent years also contributed to increased interest in video-assisted thoracoscopic surgery (VATS) thymomectomy (7). Although some single-center studies have shown no statistical differences in diseasefree survival between thymectomy and thymomectomy, the follow-up durations were relatively short despite of the rarity and the indolent nature of thymomas (2,3).…”

Section: Introductionmentioning

confidence: 99%

Thymectomy versus tumor resection for early-stage thymic malignancies: a Chinese Alliance for Research in Thymomas retrospective database analysis

Shen

et al. 2016

J. Thorac. Dis.

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Background: To evaluate the surgical outcomes of tumor resection with or without total thymectomy for thymic epithelial tumors (TETs) using the Chinese Alliance for Research in Thymomas (ChART) retrospective database. Methods: Patients without preoperative therapy, who underwent surgery for early-stage (Masaoka-Koga stage I and II) tumors, were enrolled for the study. They were divided into thymectomy and thymomectomy groups according to the resection extent of the thymus. Demographic and surgical outcomes were compared between the two patients groups.Results: A total of 1,047 patients were enrolled, with 796 cases in the thymectomy group and 251 cases in the thymomectomy group. Improvement rate of myasthenia gravis (MG) was higher after thymectomy than after thymomectomy (91.6% vs. 50.0%, P<0.001). Ten-year overall survival was similar between the two groups (90.9% after thymectomy and 89.4% after thymomectomy, P=0.732). Overall, recurrence rate was 3.1% after thymectomy and 5.4% after thymomectomy, with no significant difference between the two groups (P=0.149). Stratified analysis revealed no significant difference in recurrence rates in MasaokaKoga stage I tumors (3.2% vs. 1.4%, P=0.259). However in patients with Masaoka-Koga stage II tumors, recurrence was significantly less after thymectomy group than after thymomectomy (2.9% vs. 14.5%, P=0.001).

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Comparison of surgical techniques for early-stage thymoma: Feasibility of minimally invasive thymectomy and comparison with open resection

Cited by 139 publications

References 28 publications

A comparison of three approaches for the treatment of early-stage thymomas: robot-assisted thoracic surgery, video-assisted thoracic surgery, and median sternotomy

A comparison of three approaches for the treatment of early-stage thymomas: robot-assisted thoracic surgery, video-assisted thoracic surgery, and median sternotomy

Video-assisted and minimally-invasive open chest surgery for the treatment of mediastinal tumors and masses

Thymectomy versus tumor resection for early-stage thymic malignancies: a Chinese Alliance for Research in Thymomas retrospective database analysis

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