Long-term oncological outcome in thymic malignancies: videothoracoscopic versus open thymectomy
Complete resection is the standard of care for thymic malignancies. There is still a debate about the optimal surgical approach for thymic tumors, particularly regarding long-term oncological outcome. This study aimed to compare videothoracoscopic surgery (VTS) with open surgery for thymic malignancies, regarding perioperative and long-term oncological outcomes.
A prospective study ran from 2010 to 2019. Patients with thymoma or thymic carcinoma underwent complete thymectomy via VTS or open surgery and were followed up. The long-term oncological outcome was disease recurrence.
There were 29 patients in the VTS group and 35 patients in the open group with an average follow-up period of 80 months. The VTS approach significantly shortened operative duration (89.7 versus 116.9 min), caused less blood loss (56.9 versus 176.3 ml), reduced pain score (4.8 versus 6.7), and shortened chest drainage duration (2.1 versus 3.1 days) as well as hospital stay (5.1 versus 7.7 days). The two groups were comparable in long-term oncological outcome (two recurrences in the VTS group and one in the open group).
Compared to open surgery, VTS leads to superior perioperative outcomes and a comparable long-term oncological outcome. The authors advocate the VTS approach as a routine option for the surgery of thymic malignancies.
Main novel aspects
Videothoracoscopic surgery is less traumatic and has faster recovery times than open surgery, with a comparable long-term oncological outcome.
KeywordsVideo-assisted thoracoscopic surgery Thoracotomy Sternotomy Thymoma Thymic malignancy
All authors contributed to the study conception and design. Material preparation as well as data collection and analysis were performed by Huynh Quang Khanh, Nguyen Viet Dang Quang, and Nguyen Lam Vuong. The first draft of the manuscript was written by Huynh Quang Khanh and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Compliance with ethical guidelines
Conflict of interest
H.Q. Khanh, N.V.D. Quang, T.Q. Tien, and N.L. Vuong declare that they have no competing interests.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration. Informed consent was obtained from all patients for being included in the study.
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