Outcome of an Original Video-Assisted Thoracoscopic Extended Thymectomy for Thymoma

被引:48
作者
Takeo, Sadanori
Tsukamoto, Shuichi
Kawano, Daigo
Katsura, Masakazu
机构
[1] Natl Hosp Org, Dept Gen Thorac Surg, Kyushu Med Ctr, Fukuoka, Japan
[2] Natl Hosp Org, Dept Clin Res, Kyushu Med Ctr, Fukuoka, Japan
关键词
MYASTHENIA-GRAVIS; THYMIC CARCINOMA; PROGNOSIS; CLASSIFICATION; TUMORS; SURVIVAL; SURGERY; STERNUM; VATET;
D O I
10.1016/j.athoracsur.2011.07.054
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Video-assisted thoracoscopic extended thymectomy (VATET) for a thymoma larger than 5 cm in size is still technically difficult. Methods. Thirty-five patients with clinical Masaoka stage I thymoma underwent an original VATET procedure between November 1998 and December 2009. Results. All patients successfully underwent VATET, and none required conversion to a median sternotomy. Two patients also underwent partial resection of the lung and pericardium. Although there were no perioperative deaths, 3 patients experienced minor complications. The average tumor size was 5.2 cm. Fifteen tumors were larger than 5 cm. Pathologically, 15 were Masaoka stage I, 19 were stage II, and one was stage III. There were no significant differences in the tumor size between stages I and II. There were two type A, eight type AB, 15 type B1, five type B2, and three type B3 tumors and two thymic carcinomas. Twenty tumors were located in the right side of the body, five were in the middle, and ten were on the left. There were no differences in tumor size or pathologic stage according to location. There were also no differences in pathologic stage according to tumor size. The average follow-up period was 65 months. One patient showed recurrence to the bilateral lung 3.5 years after the procedure. After resection, this patient was free of disease 5 years after the first procedure. There has been no recurrence in any of the other patients. Conclusions. Our original VATET procedure may be indicated for patients with clinical Masaoka stages I and II thymoma and in those with tumors larger than 5 cm. (Ann Thorac Surg 2011;92:2000-6) (C) 2011 by The Society of Thoracic Surgeons
引用
收藏
页码:2000 / 2006
页数:8
相关论文
共 30 条
[1]  
[Anonymous], 1999, WHO INT HISTOLOGICAL
[2]  
[Anonymous], ATLAS TUMOR PATHOL 3
[3]  
Aubert A, 2004, ANN THORAC SURG, V77, P1878, DOI 10.1016/j.athoracsur.2003.04.008
[4]   THYMOMA - A MULTIVARIATE-ANALYSIS OF FACTORS PREDICTING SURVIVAL [J].
BLUMBERG, D ;
PORT, JL ;
WEKSLER, B ;
DELGADO, R ;
ROSAI, J ;
BAINS, MS ;
GINSBERG, RJ ;
MARTINI, N ;
MCCORMACK, PM ;
RUSCH, V ;
BURT, ME .
ANNALS OF THORACIC SURGERY, 1995, 60 (04) :908-914
[5]   Thymic carcinoma: Current staging does not predict prognosis [J].
Blumberg, D ;
Burt, ME ;
Bains, MS ;
Downey, RJ ;
Martini, N ;
Rusch, V ;
Ginsberg, RJ .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1998, 115 (02) :303-308
[6]  
Blumberg D, 1998, J THORAC CARDIOVASC, V115, P308
[7]   Early experience with robot-assisted surgery for mediastinal masses [J].
Bodner, J ;
Wykypiel, H ;
Greiner, A ;
Kirchmayr, W ;
Freund, MC ;
Margreiter, R ;
Schmid, T .
ANNALS OF THORACIC SURGERY, 2004, 78 (01) :259-266
[8]   Correlation of the WHO schema for the classification of thymic epithelial neoplasms with prognosis - A retrospective study of 90 tumors [J].
Chalabreysse, L ;
Roy, P ;
Cordier, JF ;
Loire, R ;
Gamondes, JP ;
Thivolet-Bejui, F .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 2002, 26 (12) :1605-1611
[9]   New WHO histologic classification predicts prognosis of thymic epithelial tumors - A clinicopathologic study of 200 thymoma cases from China [J].
Chen, G ;
Marx, A ;
Chen, WH ;
Yong, J ;
Puppe, B ;
Stroebel, P ;
Mueller-Hermelink, HK .
CANCER, 2002, 95 (02) :420-429
[10]  
Iablonskii P K, 2005, Vestn Khir Im I I Grek, V164, P38