Odaka Makoto, Tsukamoto You, Shibasaki Takamasa, Mori Shohei, Asano Hisatoshi, Yamashita Makoto, Morikawa Toshiaki
Department of Surgery, Jikei University School of Medicine, Minatoku, Tokyo 105-0003, Japan.
J Vis Surg. 2017 Apr 10;3:54. doi: 10.21037/jovs.2017.03.18. eCollection 2017.
Thymoma remains the most common primary anterior mediastinal neoplasm. Surgical resection remains central to the treatment of thymoma, with thoracoscopic thymectomy (TT) being increasingly performed. This present review article aimed to summarize current studies comparing TT and open thymectomy (OT). Recently, most patients with Masaoka stage I-II thymoma have been receiving TT. This procedure is associated with a significantly shorter post-operative hospital stay, decreased intraoperative blood loss, and fewer complications compared with OT. Recurrence rates of thymoma after TT range from 0% to 6.7%, and the 5-year disease-free survival (DFS) ranges from 83.3% to 96%. The oncological outcomes of TT are comparable to that of OT. Masaoka stage and the World Health Organization (WHO) type classification are valuable predictors of the prognosis of thymoma; hence, the optimal treatment for thymoma should be performed according to these two. TT is less invasive, with equivalent oncological outcomes, when compared with the OT. Minimally invasive surgery including TT for stage I-II thymomas is becoming the mainstay of therapy.
胸腺瘤仍然是最常见的原发性前纵隔肿瘤。手术切除仍然是胸腺瘤治疗的核心,胸腔镜胸腺切除术(TT)的开展越来越多。这篇综述文章旨在总结目前比较TT和开放性胸腺切除术(OT)的研究。最近,大多数Masaoka I-II期胸腺瘤患者接受了TT。与OT相比,该手术术后住院时间显著缩短,术中失血减少,并发症更少。TT术后胸腺瘤的复发率为0%至6.7%,5年无病生存率为83.3%至96%。TT的肿瘤学结局与OT相当。Masaoka分期和世界卫生组织(WHO)分型是胸腺瘤预后的重要预测指标;因此,应根据这两者对胸腺瘤进行最佳治疗。与OT相比,TT的侵入性较小,肿瘤学结局相当。包括TT在内的I-II期胸腺瘤的微创手术正成为治疗的主流。