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It is feasible to operate on pathological Masaoka stage I and II thymoma patients with video-assisted thoracoscopy: analysis of factors for a successful resection

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Abstract

Background

The objectives of this study were to evaluate the feasibility of video-assisted thoracoscopic (VATS) thymoma resection and to analyze the factors contributing to a successful perioperative period.

Methods

Fifty-one patients with thymoma underwent VATS with the aim of thymoma resection. Four patients underwent minithoracotomy [due to technical difficulties, including small chest cavity, high body mass index (BMI), and disintegration of the capsule] and three patients underwent sternotomy (due to invasion of major vascular structures). The seven open-converted patients and seven other patients who underwent complete VATS thymoma resection but experienced prolonged hospital stay (≥7 days) formed Group B (n = 14), namely, the unsuccessful group, while successful VATS thymoma resection patients formed Group A (n = 37). The groups were compared with each other in terms of the characteristics of patients, tumors, and perioperative period.

Results

Patients’ characteristics, tumor size, WHO histologic type, and complications were similar in both Groups A and B (p > 0.05). Patients with Masaoka stage I and II thymomas were significantly more frequent in Group A (p < 0.01). Tumor size was a statistically insignificant variable for the determination of a successful VATS thymoma resection (p = 0.3). Masaoka stage and the size of the thymoma did not have any correlation with each other (p > 0.05).

Conclusions

The size of the thymoma was not observed to be correlated with Masaoka stage and it was not noted to be an important factor in successful VATS thymoma resection. A higher Masaoka stage (III and IVa) was found to be the only variable that predicted unsuccessful situations. Thus, Masaoka stage, rather than the size of the thymoma, should be the main concern for the surgeon.

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Disclosures

Drs Alper Toker, Suat Erus, Sedat Ziyade, Berker Ozkan and Serhan Tanju have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey

    Alper Toker, Suat Erus, Berker Ozkan & Serhan Tanju

  2. Department of Thoracic Surgery, Vakif Hospital, Bezmialem University, Istanbul, Turkey

    Sedat Ziyade

  3. Hamidiye Mah. Barisyolu Cad., Agaoglu MyCountry Sitesi G/5 No:3 Cekmekoy, Istanbul, Turkey

    Alper Toker

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  1. Alper Toker
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  2. Suat Erus
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  3. Sedat Ziyade
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  4. Berker Ozkan
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  5. Serhan Tanju
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Corresponding author

Correspondence to Serhan Tanju.

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Toker, A., Erus, S., Ziyade, S. et al. It is feasible to operate on pathological Masaoka stage I and II thymoma patients with video-assisted thoracoscopy: analysis of factors for a successful resection. Surg Endosc 27, 1555–1560 (2013). https://doi.org/10.1007/s00464-012-2626-4

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  • DOI: https://doi.org/10.1007/s00464-012-2626-4

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