Purpose: This study was undertaken to investigate the efficacy of a video-assisted thoracoscopic (VATS) approach for stage I and II thymoma through comparisons with the transsternal approach.
Methods: The indications for VATS resection were clinical stage I or II thymoma, a tumor less than 50 mm, located within the thymic lobes and separated from the brachiocephalic vein. Data were collected between 1995 and 2007.
Results: Twenty-seven patients underwent total thymectomy (15 by VATS and 12 by the transsternal approach). The mean tumor size was 36.3 (22-50) mm for VATS and 37.6 (15-55) mm for the transsternal group (p = 0.7862). The mean lengths of the operation were 249.8 min and 227.9 min (p = 0.2728), respectively. The mean intraoperative blood loss was significantly lower in VATS, at 92.3 ml, than the 225.1 ml lost in the transsternal group (p = 0.0020). The morbidity rates were 13.3 and 8.3% (p = 0.6812), respectively. There was no mortality in either group. The mean follow-up periods were 109.0 (37-145) months following VATS and 102.0 (44-175) months following the transsternal approach. One stage II patient developed pleural dissemination three years after VATS resection. Other patients survived with no recurrence.
Conclusions: VATS resection of early stage thymoma can be performed with less bleeding and with a comparable prognosis to the transsternal approach. VATS resection should thus be considered as a viable option for treatment.