Triviño Ana, Congregado Miguel, Loscertales Jesús, Cozar Fernando, Pinos Nathalie, Carmona Patricia, Jiménez-Merchán Rafael, Girón-Arjona Juan Carlos
Departamento de Cirugía Torácica, Hospital General de Albacete, Albacete, España.
Departamento de Cirugía Torácica General, Hospital Universitario Virgen Macarena, Sevilla, España.
Cir Esp. 2015 Aug-Sep;93(7):466-71. doi: 10.1016/j.ciresp.2014.02.021. Epub 2014 Jun 2.
Video-assisted thoracic surgery (VATS) has significantly developed over the last decade. However, a VATS approach for thymoma remains controversial. The aim of this study was to evaluate the feasibility of VATS thymectomy for the treatment of early-stage thymoma and to compare the outcomes with open resection.
A comparative study of 59 patients who underwent surgical resection for early stage thymoma (VATS: 44 and open resection: 15) between 1993 and 2011 was performed. Data of patient characteristics, morbidity, mortality, length of hospital stay, the relationship between miasthenia gravis-thymoma, recurrence, and survival were collected for statistical analysis.
Thymomas were classified according to Masaoka staging system: 38 in stage I (VATS group: 29 and open group: 9) and 21 in stage II (VATS group: 15 and open group: 6). The mean tumor size in the open group was 7.6cm (13-4cm) and in the VATS group 6.9cm (12-2.5cm). The average length of stay was shorter in the VATS group than in the open group (P<.001). No significant differences were found in the estimated recurrence-free and overall 5-year survival rates (96% vs. 100%) between the 2 groups.
VATS thymectomy for early-stage thymoma is technically feasible and is associated with a shorter hospital stay. The 5-year oncologic outcomes were similar in the open and VATS groups.
在过去十年中,电视辅助胸腔镜手术(VATS)有了显著发展。然而,VATS用于胸腺瘤的治疗仍存在争议。本研究的目的是评估VATS胸腺切除术治疗早期胸腺瘤的可行性,并将其结果与开放切除术进行比较。
对1993年至2011年间因早期胸腺瘤接受手术切除的59例患者进行了一项对比研究(VATS组:44例;开放切除术组:15例)。收集患者特征、发病率、死亡率、住院时间、重症肌无力与胸腺瘤的关系、复发及生存情况的数据进行统计分析。
胸腺瘤根据Masaoka分期系统进行分类:I期38例(VATS组:29例;开放组:9例),II期21例(VATS组:15例;开放组:6例)。开放组肿瘤平均大小为7.6cm(13 - 4cm),VATS组为6.9cm(12 - 2.5cm)。VATS组的平均住院时间比开放组短(P <.001)。两组之间的估计无复发生存率和5年总生存率无显著差异(96%对100%)。
VATS胸腺切除术治疗早期胸腺瘤在技术上是可行的,且住院时间较短。开放组和VATS组的5年肿瘤学结果相似。