Background: Video-assisted thoracoscopic surgery (VATS) in thymectomy has shown safe and effective with many advantages in myasthenia gravis (MG) patients with or without thymoma than transsternal approach. This video aims to show the procedure of extended thymectomy via a cervical incision additional to bilateral VATS approach in a MG patient with an early stage thymoma.
Methods: The patient was a 46-year-old male who had onset of symptoms of blurred vision, dysarthria and dysphagia for 10 months before administration. A diagnosis of MG was then confirmed using anticholinesterase test and electromyography test by neurologists. A CT scan showed enlarged thymus and a mass close to the left innominate vein in the anterior mediastinum with a size of 12 mm × 13 mm. Without any contradictions, the patient was planned to receive a procedure of extended thymectomy.
Results: The patient recovered with no complications and was discharged on the 8th postoperative day. Histological pathology examination revealed a type B3 thymoma of Masaoka stage II.
Conclusions: Oncological principles and immunological considerations are equally important in surgery for the MG patients with thymoma. All the thymus gland in the mediastinum including ectopic thymic tissue in the cervical region should be removed in the procedure. In conclusion, we suggest this approach to be safe and feasible for thymoma surgery in patients with MG.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637920 | PMC |
http://dx.doi.org/10.21037/jovs.2017.05.04 | DOI Listing |
Front Surg
November 2024
Department of Thoracic Surgery, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Türkiye.
Kyobu Geka
September 2024
Division of Thoracic Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Minimally invasive thoracoscopic thymectomy has been indicated in patients with non-invasive thymic epithelial tumors or myasthenia gravis. Sub-xiphoid thymectomy has an advantage of similar surgical view of median sternotomy as compare to lateral approach. Since anterior mediastinum is anatomically limited space, robotic approach with carbon dioxide (CO2) insufflation has led a drastic innovation in thymectomy.
View Article and Find Full Text PDFSurg Case Rep
November 2024
Department of Thoracic Surgery, Sapporo Medical University School of Medicine and Hospital, South 1, West 16, Chuo-Ku, Sapporo, Hokkaido, Japan.
Background: We present the case of a rare occurrence of an anterior mediastinal mature teratoma extending into the neck, commonly referred to as a cervicothoracic mature teratoma.
Case Presentation: A 19-year-old female presented with right-sided neck pain and swelling, which were found to be attributed to a 14 cm cystic lesion originating from the right thyroid lobe and extending into the mediastinum. A diagnosis of mediastinal teratoma with extension to the neck was made.
Gen Thorac Cardiovasc Surg
October 2024
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan.
Objective: Following the introduction of robot-assisted thoracoscopic surgery (RATS) as a health insurance-covered treatment in Japan, we investigated the current status and impact of the expansion of the indications for RATS for mediastinal tumors.
Methods: Between 2018 and 2022, 209 cases of total mediastinal tumor resection were performed in our hospital. The study period was divided into the first half (January 2018 to June 2020) and the second half (July 2020 to December 2022), and perioperative parameters were compared between the two groups.
Surg Case Rep
September 2024
Department of Pathology, Japanese Red Cross Akita Hospital, 222-1 Nawashirosawa, Saruta Kamikitate, Akita, 010-1495, Japan.
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