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OBJECTIVE: A standard surgical treatment of thymoma and thymic carcinoma is a complete enbloc resection of the tumor and thymus. Video-assisted thoracoscopic thymectomy is commonly performed bilaterally to remove thymus. We performed unilateral approach and evaluated the surgical and oncological outcomes of thymoma and thymic carcinoma.
METHODS: We retrospective reviewed 31 consecutive patients from 2011 to 2014 who received unilateral video-assisted thoracoscopic near total thymectomy for thymic tumor at single institution in Korea. In the case of stage IVA, thymectomy with partial pleurectomy was performed for removal of all metastatic lesions. We analyzed patient demographics, perioperative management and patient outcomes.
RESULTS: A total of 31 patients were included in our study. The mean age was 52.5 years (range, 28 -77 years). 26 patients were thymoma (type A(2), Type AB(3), Type B1(10), Type B2 (4) Type B3 (7)) and 5 patients were thymic carcinoma. 10 patients were stage I, 19 patients were stage II, and 2 patients were stage IVA. The right side approach was often preferred (Rt; 21 cases, Lt;10 cases). The mean hospital stay was 2.4(±2.0) days and mean duration of chest tube drainage was 1.3(±1.2) days. There was no morbidity and mortality. The conversion rate to open thymectomy was 6.4% (n=2). The median follow-up time for all patients was 28.3 month (range, 0.3 - 51.5 months). During follow-up period, disease recurrence occurred in 1 (3.2%) with stage I thymoma (type B1). The 3-year overall survival rate was 100%, and the 3-year recurrence free survival was 96.3%.
CONCLUSIONS: Unilateral video-assisted thoracoscopic thymectomy for thymoma or thymic carcinoma is feasible with good surgical and early oncological outcomes. Further investigation for long-term oncological outcomes is required to confirm these findings.