AI Article Synopsis
- Traditional sternotomy is the standard treatment for thymomas, but minimally invasive techniques like video-assisted and robot-assisted thymectomy are becoming more popular despite concerns about tumor manipulation and recurrence.
- In a study involving 52 patients undergoing minimally invasive thymectomy, most (94.2%) had video-assisted surgery, resulting in no surgery-related complications and no recurrence detected over a median follow-up of 43 months.
- The findings suggest that minimally invasive thymectomy is a safe and effective option for thymoma treatment with promising long-term outcomes.
Article Abstract
Background: Traditionally, sternotomy has been the gold standard approach for the treatment of thymomas. However, interest in minimally invasive techniques such as video-assisted and robot-assisted thymectomy is gaining momentum. Concerns have been raised over the possibility of en-bloc resection using minimal access techniques due to limited working space and increased tumour manipulation leading to tumour breach and recurrence.
Methods: An observational cohort study was conducted at a tertiary referral centre from 1 April 2012 to 31 December 2020 and followed up until 31 March 2023. Consecutive patients of thymoma were evaluated for demography, symptoms and imaging preoperatively and included for the study. Post minimally invasive thymectomy, surgical, neurological and oncological outcomes were evaluated through out-patient and telephonic follow-up.
Results: Fifty-two patients underwent minimally invasive thymectomy. Video-assisted thoracoscopic surgery for thymectomy was used in 49 patients (94.2%) with 3 (5.8%) patients undergoing robot-assisted thoracoscopic surgery. Median tumour size was 4 cm (interquartile range (IQR) 3-5) with a median operative duration of 150 min (IQR 120-180), blood loss of 135 ml (IQR 42.5-250), post-operative stay of 3 days (IQR 2-4) and no 30-day surgery related morbidity and mortality. Annual contrast-enhanced computed tomography imaging, available in 46 (88.5%) patients, showed no recurrence at a median follow-up of 43 (IQR, 21-75) months. No symptoms suggesting recurrence was noted at a median clinical follow-up of 57 (IQR 44-95.5) months and 88.5% patients were expected to survive a period of 10 years.
Conclusion: Minimally invasive thymectomy is technically feasible with minimal morbidity and acceptable intermediate-term oncological outcomes in patients suffering with thymoma.
Trial Registration: Institute ethical committee approval: Ref no. IECPG-551/14.11.2018.Clinical Trial Registry of India: Ref no. CTRI/2019/04/018784.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638431 | PMC |
| http://dx.doi.org/10.1007/s12055-024-01761-2 | DOI Listing |
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