Extended thymectomy by a cervical incision additional to bilateral VATS approach.

J Vis Surg

Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

Published: June 2017

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.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637920PMC
http://dx.doi.org/10.21037/jovs.2017.05.04DOI Listing

Publication Analysis

Top Keywords

extended thymectomy
8
thymectomy cervical
8
cervical incision
8
incision additional
8
additional bilateral
8
bilateral vats
8
vats approach
8
patients thymoma
8
procedure extended
8
surgery patients
8

Similar Publications

Surgical treatment of thymic epithelial tumor and myasthenia gravis.

Front Surg

November 2024

Department of Thoracic Surgery, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Türkiye.

Article Synopsis
  • * Thymomas grow slowly and are localized, while thymic carcinomas grow quickly and can spread, with respective 5-year survival rates of 78% and 30%.
  • * Treatment depends on tumor resectability, starting with surgery for early-stage cases, followed by chemotherapy for more advanced stages, while conditions like myasthenia gravis are associated with these tumors and can be treated through various methods, including extended thymectomy.
View Article and Find Full Text PDF

[Thymectomy via Trans-subxiphoid Approach].

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 PDF

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.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF
Article Synopsis
  • A 65-year-old female with myasthenia gravis underwent surgery for a tumor suspected to be a thymoma following CT scans that indicated an anterior mediastinal mass.
  • During surgery, it was found that her tumor was a combination of a B3 thymoma and thymic squamous cell carcinoma, which is a rare occurrence.
  • Post-surgery, she received adjuvant radiotherapy and is currently being monitored with no signs of cancer recurrence noted in follow-up scans.*
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!