F-055 MINIMALLY INVASIVE THYMECTOMY FOR LARGE THYMOMAS IS ASSOCIATED WITH LOW PERIOPERATIVE MORBIDITY AND MORTALITY
Publication Title
23rd European Conference on General Thoracic Surgery
Document Type
Conference Proceeding
Publication Date
5-2015
Keywords
washington; swedish; swedish thoracic surgery
Abstract
Objectives: The size of thymic masses has generally been accepted as a determinant of operative approach, although no universal guidelines exist. Surgeons agree that lesions ≤3 cm are amenable to minimally invasive approaches which may otherwise limit visualization and specimen removal. Although removal of larger tumours has been published as case reports, no studies report perioperative outcomes of a patient cohort. Methods: We retrospectively reviewed patients with encapsulated thymomas ≥3 cm who underwent a thymectomy at our institution from 2001 to 2014, including a minimally invasive approach from 2008. Patients with carcinoma, metastases at presentation, or those who underwent induction chemoradiation were excluded. Patients were divided into 2 groups based on the operative approach: group 1 - minimally invasive and group 2 – open. Each was further subdivided based on tumour size 3-5 cm and >5 cm. Complications were graded according to the Ottawa Classification. Results are reported as median and interquartile ranges unless otherwise stated. Results: A total of 41 patients were evaluated (22 in group 1 and 19 in group 2). The median age was 59 (49–68) and 23 (56%) were male. The tumour size was not significantly different between the groups: group 1–6 cm (4–6) vs group 2–6 cm (5–9), P = 0.08. Only 2 patients (10%) in group 1 encountered major postoperative morbidity and there were no perioperative mortalities. There were no significant changes in pathologic stage or overall complications and mortality. Postoperative narcotic analgesia and overall length of stay was significantly reduced in group 1. Conclusions: In thymomas larger than 3 cm, a minimally invasive thymectomy is feasible and is associated with lower morbidity in addition to a lower requirement for postoperative narcotic analgesia and decreased ICU and shorter hospital stay. A prolonged postoperative surveillance is required to determine the oncologic efficacy of this resection approach. Disclosure: No significant relationships
Clinical Institute
Cancer
Specialty/Research Institute
Oncology
Specialty/Research Institute
Surgery
DOI
10.1093/icvts/ivv204.55
