Technique for Myasthenia Gravis

Aramini, Beatrice; Jiang, Fan

doi:10.1016/j.thorsurg.2018.12.010

Cited by 15 publications

(7 citation statements)

References 43 publications

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“…When it comes to decide which surgical technique is best in resecting tumors in the anterior mediastinum, the subxiphoidal approach is the most fashionable and the number one player in specialized thoracic centers [ 8–11 ]. With thymic pathologies being the most common surgical indications for this technique, it is quite consequential to apply it for rather rare mediastinal pathologies like MEPAs.…”

Section: Discussionmentioning

confidence: 99%

Technique for ectopic intrathymic parathyroid adenoma: the uniportal subxiphoid approach

Hartert

Tripsky

Huertgen

2021

Journal of Surgical Case Reports

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Parathyroid adenomas (PAs) are the main cause for primary hyperparathyroidism with almost a quarter of them being ectopic, most likely located in the superior mediastinum within the thymus. Besides the challenge of their prompt and correct diagnosis, utmost care should be taken during surgical resection as leaving behind parathyroid tissue may result in metastasis and recurrence of hyperparathyroidism. With tumor excision via median sternotomy or thoracotomy being the conventional approaches for a long period, video-assisted thoracoscopic surgery (VATS) is of gaining popularity. As the lateral thoracic approach lacks in clarity on the contralateral mediastinum, the newest evolution in VATS—the supxiphoid approach—closes the gap to the insufficient intraoperative visibility and hence optimizes postoperative outcome. We hereby present the practicality of the uniportal subxiphoid resection of an ectopic mediastinal PA.

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Section: Discussionmentioning

confidence: 99%

Technique for ectopic intrathymic parathyroid adenoma: the uniportal subxiphoid approach

Hartert

Tripsky

Huertgen

2021

Journal of Surgical Case Reports

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“…An additional 2 cm skin incision is made at the level of the fourth intercostal anterior axillary lines on the right side for the thoracoscope placement. The hooks are placed in a 1 cm incision, which was made at the level of the jugular process [ 34 ].…”

Section: Surgical Treatment For Thymic Tumormentioning

confidence: 99%

Thymoma and Thymic Carcinoma: Surgical Resection and Multidisciplinary Treatment

Zhang

Lin

Aramini

et al. 2023

Cancers

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Thymoma and thymic carcinoma are the most common tumors of the anterior mediastinum and a relatively rare type of thoracic cancer. The prerequisite for surgery is clinical staging and operative evaluation, both of which are based on medical imaging. The best strategy for treating a thymic epithelial tumor is surgical resection of the organ and surrounding tissue. Thymectomy modalities vary, including open surgery and minimally invasive surgery, and surgeons have used various innovations to better meet the needs of the procedure; therefore, it is critical to select the appropriate procedure based on the patient’s characteristics. Evaluation of resectability is the first step of surgical resection for thymic tumors without distant metastasis. The decision regarding unresectability should be made carefully. During subsequent chemotherapy or chemoradiotherapy, reevaluation of whether an area is resectable or not remains essential. Despite numerous technological advances in the surgical treatment of thymic tumors, several contentious issues remain, including the selection of surgical approaches for difficult cases, the selection of video-assisted thoracoscopic approaches, the evaluation of resectability, minimally invasive surgery for locally advanced thymic tumors, lymphadenectomy in thymic tumors, neoadjuvant therapy for thymic tumors, debulking surgery, and salvage surgery. In solving these problems, the surgeon’s judgment, surgical experience, and surgical skills are especially important.

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“…Since minimally invasive surgical strategies are becoming increasingly popular, traditional surgical approaches are gradually being replaced. For thymectomy, the trans- sternal approach has long been accepted as the standard surgical method, but video-assisted thoracoscopic surgery (VATS) techniques are a powerful emerging option [ 1 ]. The latest trend is uniportal subxiphoid VATS, which (1) provides a cinematographic view of the anterior mediastinum and therefore enables radical thymectomy, (2) avoids intercostal nerve damage and therefore reduces postoperative pain, and (3) leads to a faster recovery and therefore lowers expenses [ 2 , 3 ].…”

Section: Case Reportmentioning

confidence: 99%

Non-intubated Uniportal Subxiphoid Video-Assisted Thoracoscopic Surgery for Extended Thymectomy in Myasthenia Gravis Patients: A Case Series

et al. 2022

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Minimally invasive strategies are increasingly popular in patients with myasthenia gravis (MG)-associated thymomas. Within the context of video-assisted thoracoscopic surgery (VATS) as a widely known minimally invasive option, the most recent achievement is uniportal subxiphoid VATS. In MG patients, it is mandatory (1) to minimize perioperative interference with administered anesthetics to avoid complications and (2) to achieve a complete surgical resection, as the prognosis essentially depends on radical tumor resection. In order to fulfill these criteria, we merged this surgical technique with its anesthesiologic counterpart: regional anesthesia with the maintenance of spontaneous ventilation via a laryngeal mask. Non-intubated uniportal subxiphoid VATS for extended thymectomy allowed radical thymectomy in all MG patients with both rapid symptom control and fast recovery.

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Technique for Myasthenia Gravis

Cited by 15 publications

References 43 publications

Technique for ectopic intrathymic parathyroid adenoma: the uniportal subxiphoid approach

Technique for ectopic intrathymic parathyroid adenoma: the uniportal subxiphoid approach

Thymoma and Thymic Carcinoma: Surgical Resection and Multidisciplinary Treatment

Non-intubated Uniportal Subxiphoid Video-Assisted Thoracoscopic Surgery for Extended Thymectomy in Myasthenia Gravis Patients: A Case Series

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