Bilkhu Rajdeep, Billè Andrea
Department of Thoracic Surgery, Guy's Hospital London, London, UK.
Department of Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
Mediastinum. 2021 Jun 25;5:17. doi: 10.21037/med-21-10. eCollection 2021.
Patients who have undergone surgical resection of thymoma may present later with recurrence of disease. This is most commonly in the pleural cavity. Surgery for recurrent thymoma has been shown to have a survival advantage. During the COVID-19 pandemic, there has been a reduction in capacity for routine healthcare provision. We present the outcomes of patients undergoing surgery for recurrent thymoma during the COVID-19 pandemic and our protocols to allow surgery to be performed during this time. Retrospective review of patients undergoing surgery for recurrent thymoma between March 2020 and the March 2021 at a single centre was performed. Preoperative demographic data, postoperative outcomes and the incidence of complications or postoperative COVID-19 infection were assessed. Over a 4-year period, and under the care of a single surgeon, 7 operations were performed for recurrent thymoma. Of these, three patients were operated during the COVID-19 pandemic. All patients had a history of myasthenia gravis (MG) and all patients presented with disease recurrence in the pleural cavity. No patients had post-operative complications and no patients tested positive for COVID-19 in the pre or postoperative period. Complete macroscopic resection was achieved in all patients. Surgery for recurrent thymoma can be performed safely and complete macroscopic resection can be achieved. It is possible to offer surgery with low risk of perioperative COVID infection and related morbidity and mortality. Given the benefits seen in survival and disease-free survival, we believe surgery for recurrent thymoma should continue to be advocated even during the current viral pandemic.
接受过胸腺瘤手术切除的患者后期可能会出现疾病复发。最常见于胸腔。复发性胸腺瘤手术已显示出具有生存优势。在新冠疫情期间，常规医疗服务的能力有所下降。我们展示了新冠疫情期间接受复发性胸腺瘤手术患者的治疗结果以及我们在此期间允许进行手术的方案。对2020年3月至2021年3月在单一中心接受复发性胸腺瘤手术的患者进行了回顾性研究。评估了术前人口统计学数据、术后结果以及并发症或术后新冠病毒感染的发生率。在4年期间，在一位外科医生的照料下，对复发性胸腺瘤进行了7例手术。其中，3例患者在新冠疫情期间接受了手术。所有患者均有重症肌无力（MG）病史，且所有患者均表现为胸腔内疾病复发。没有患者出现术后并发症，也没有患者在术前或术后新冠病毒检测呈阳性。所有患者均实现了肉眼下完全切除。复发性胸腺瘤手术可以安全进行，并且可以实现肉眼下完全切除。可以在围手术期新冠病毒感染及相关发病率和死亡率风险较低的情况下进行手术。鉴于在生存和无病生存方面看到的益处，我们认为即使在当前的病毒大流行期间，复发性胸腺瘤手术仍应继续提倡。
