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Thymoma invasive surgery

Louqian Zhang, Ming Li, Feng Jiang, Zhi Zhang, Qin Zhang, Lin Xu
BACKGROUND: Thymectomy is increasingly being performed via minimally invasive approaches. The present study aimed to assess the safety and feasibility of the subxiphoid approach to video-assisted thoracic surgery (VATS) compared with the lateral intercostal approach VATS. METHODS: Patients who underwent VATS thymectomy via subxiphoid and lateral intercostal approaches in our hospital between 2015 and 2018 wereretrospectively analyzed. A series of perioperative outcomes, including clinical and surgical results, postoperative pain scores and cosmetic results, was compared in a propensity score matching analysis...
January 21, 2019: International Journal of Surgery
Enrico Ruffini, Francesco Guerrera, Alessandro Brunelli, Stefano Passani, Danilo Pellicano, Pascal Thomas, Dirk Van Raemdonck, Gaetano Rocco, Federico Venuta, Walter Weder, Frank Detterbeck, Pierre-Emmanuel Falcoz
OBJECTIVES: We queried the European Society of Thoracic Surgeons (ESTS) prospective thymic database for descriptive analysis and for comparison with the ESTS retrospective thymic database (1990-2010). METHODS: Data were retrieved (January 2007-November 2017) for 1122 patients from 75 ESTS institutions. RESULTS: There were 484 (65%) thymomas, 207 (28%) thymic carcinomas and 49 (7%) neuroendocrine thymic tumours. Staging (Masaoka) included 483 (67%) stage I and II, 100 (14%) stage III and 70 (10%) stage IV tumours...
January 10, 2019: European Journal of Cardio-thoracic Surgery
Zhu Mei, He Wang, Shengnan Ren, Juan Wei, Yanhong Gu
RATIONALE: Thymic carcinoids are a rare type of malignant neuroendocrine tumors which have a poor prognosis due to their distant metastasis, invasive behaviour, and postoperative recurrence. Surgical resection is still the fundamental mode for treating thymic carcinoids. Here, we report the rapid shrinkage of an atypical thymic carcinoid with multiple metastases following chemoradiation plus octreotide as a first-line therapy PATIENT CONCERNS:: A 39-year-old Chinese man presented with chest tightness, dyspnea with a history of lumbago and untreated malignant thymoma...
November 2018: Medicine (Baltimore)
Hiromitsu Domen, Yasuhiro Hida, Masaaki Sato, Haruka Takahashi, Tatsuru Ishikawa, Yosuke Shionoya, Midori Hashimoto, Kaoru Nishiyama, Yuma Aoki, Kazuho Inoko, Syotaro Furukawa, Kazuomi Ichinokawa, Hidehisa Yamada
BACKGROUND: Thymic large cell neuroendocrine carcinoma (LCNEC) is extremely rare. The detailed clinical features of thymic LNCECs remain unknown. CASE PRESENTATION: A 90-year-old man with a history of diabetes mellitus, chronic renal failure, and an abdominal aortic aneurysm underwent computed tomography for follow-up, which showed an anterior mediastinal tumor, measuring 31 mm × 28 mm in diameter. Magnetic resonance imaging showed an iso-intensity mass on T1-weighted images and high intensity on T2-weighted images...
November 16, 2018: Surgical Case Reports
Ryo Miyata, Masatsugu Hamaji, Mitsugu Omasa, Tatsuo Nakagawa, Ryota Sumitomo, Cheng-Long Huang, Masaki Ikeda, Takuji Fujinaga, Tsuyoshi Shoji, Hiromichi Katakura, Hideki Motoyama, Daisuke Nakajima, Akihiro Ohsumi, Toshi Menju, Akihiro Aoyama, Toyofumi F Chen-Yoshikawa, Toshihiko Sato, Makoto Sonobe, Hiroshi Date
Minimally invasive surgery (MIS) has occasionally been used for selected patients with thymoma, but there is little information on the MIS approach for thymic carcinoma. The aim of this study was to evaluate survival outcomes after MIS for early-stage (Masaoka stage I-II) thymic carcinoma and thymic neuroendocrine carcinoma. A retrospective chart review of the cases recorded in our multi-institutional database was performed to identify patients who underwent resection for thymic carcinoma between 1995 and 2017...
November 14, 2018: Surgery Today
Vittorio Aprile, Pietro Bertoglio, Stylianos Korasidis, Diana Bacchin, Olivia Fanucchi, Paolo Dini, Marcello Carlo Ambrogi, Marco Lucchi
BACKGROUND: Phrenic nerve infiltration has been described in up to 33% of advanced thymomas; en-bloc resection causes diaphragmatic loss of function, with detrimental effects on pulmonary function. We report the outcomes of selected patients operated on for invasive thymoma with a "nerve sparing" technique. METHODS: From 1990 to 2015 we used "nerve sparing" surgery with the intention to treat all patients with advanced stage thymomas without preoperative evidence of hemi-diaphragmatic palsy, but with macroscopical evidence of phrenic nerve involvement...
October 15, 2018: Annals of Thoracic Surgery
Michael Peer, Sharbell Azzam, Vladislav Gofman, Mark Kushnir, Benjamin Davidson, Carmel Armon
BACKGROUND: Thymectomy is a reliable surgical method for treating patients with myasthenia gravis (MG) and benign tumors of the thymus. Despite the advantages of minimally invasive surgical approaches for resection of thymic neoplasms, there are still controversies regarding the superiority of one type of surgery over another. OBJECTIVES: To report the results of our initial Israeli experience with robotic thymectomy in 22 patients with MG and suspected benign thymic tumors...
October 2018: Israel Medical Association Journal: IMAJ
Juan P Cata, Javier D Lasala, Wendell Williams, Gabriel E Mena
Myasthenia gravis (MG) is a rare neuromuscular disorder characterized by skeletal muscle weakness. Patients with MG who have thymoma and thymic hyperplasia have indications for thymectomy. The perioperative care of patients with MG scheduled for thymus resection should be focused on optimizing their neuromuscular function, identifying factors related to postoperative mechanical ventilation, and avoiding of triggers associated with myasthenic or cholinergic crisis. Minimally invasive surgical techniques, use of regional analgesia, and avoidance or judicious administration of neuromuscular blocking drugs (NMBs) is recommended during the perioperative period...
July 29, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Emanuele Voulaz, Giulia Veronesi, Maurizio Infante, Umberto Cariboni, Alberto Testori, Pierluigi Novellis, Edoardo Bottoni, Eliseo Passera, Emanuela Morenghi, Marco Alloisio
Background: Complete thymectomy is recommended for thymic malignancies to reduce local recurrence and the likelihood of the long-term development of myasthenia gravis (MG). Thymus-conserving surgery (thymomectomy) seems to yield similar results, but evidence is still limited. The objective of this study was to assess if the oncological outcome, in terms of overall survival (OS) and disease-free survival (DFS), are comparable between radical thymectomy vs. conservative thymomectomy patients, and to assess if the outcome of the video-assisted thoracoscopic surgery (VATS) approach was similar to open surgery approach...
July 2018: Journal of Thoracic Disease
Xuefei Zhang, Zhitao Gu, Wentao Fang
Surgery is the most important therapy for thymic malignancies. The last decade has seen increasing adoption of minimally invasive thymectomy (MIT) for thymic tumors. MIT for early stage diseases has been shown to yield similar oncological results while being helpful in minimizing surgical trauma, improving postoperative recovery, and reducing incisional pain. Similar surgical and oncological principles should be observed in both minimally invasive and open procedures so as to ensure radical resection and accurate staging of the tumor...
June 2018: Journal of Thoracic Disease
Zhitao Gu, Chun Chen, Yun Wang, Yucheng Wei, Jianhua Fu, Peng Zhang, Yongyu Liu, Renquan Zhang, Keneng Chen, Zhentao Yu, Liewen Pang, Yangchun Liu, Yin Li, Yongtao Han, Hezhong Chen, Xinming Zhou, Youbin Cui, Lijie Tan, Jianyong Ding, Yi Shen, Yuan Liu, Wentao Fang
OBJECTIVES: Video-assisted thoracoscopic surgery (VATS) has been increasingly used in the management of thymic epithelial tumours. However, its oncological efficacy remains to be proved. The purpose of this study is to compare the oncological outcomes following thoracoscopic versus open surgery in the case-matched groups of patients with early-stage thymic tumours from the Chinese Alliance for Research in Thymomas (ChART) retrospective database. METHODS: Between 1994 and 2012, a total of 1087 patients who underwent surgery for UICC (Union for International Cancer Control) pathological Stage I tumours from the ChART retrospective database were recruited for this study...
December 1, 2018: European Journal of Cardio-thoracic Surgery
Haruaki Hino, Jun-Ichi Nitadori, Keiko Ohno, Seiji Kishimoto, Masatoki Takahashi, Mototsune Kakizaki, Tomio Arai, Takashi Nishimura, Jun Nakajima
An 81-year-old woman with a 2-year history of dysphagia detected a cervical mass. Computed tomography showed a thyroid tumor extending through the superior and anterior mediastinum. Analysis of an incisional biopsy specimen revealed a thymoma. Total resection of the thyroid and mediastinal tumor was performed. The thymoma invaded the anterior tracheal wall and left brachiocephalic vein. Pathologic examination revealed thymoma type B1 concomitant with B2 and B3 (World Health Organization classification), Masaoka IVb, and T3 N2 M0-IVb, with cervical lymph node metastasis...
August 2018: Annals of Thoracic Surgery
Wentao Fang, Zhitao Gu, Keneng Chen
Surgery is the most important therapy for thymic malignances. The last decade has seen increasing adoption of minimally invasive surgery (MIS) for thymectomy. MIS for early stage thymoma patients has been shown to yield similar oncological results while being helpful in minimize surgical trauma, improving postoperative recovery, and reduce incisional pain. Meanwhile, With the advance in surgical techniques, the patients with locally advanced thymic tumors, preoperative induction therapies or recurrent diseases, may also benefit from MIS in selected cases...
April 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Giuseppe Marulli, Giovanni Maria Comacchio, Marco Schiavon, Alessandro Rebusso, Marco Mammana, Davide Zampieri, Egle Perissinotto, Federico Rea
OBJECTIVES: Minimally invasive techniques seem to be promising alternatives to open approaches in the surgical treatment of early-stage thymoma, although there are controversies because of lack of data on long-term results. The aim of the study was to evaluate the surgical and oncological results after robotic thymectomy for early-stage thymoma compared to median sternotomy. METHODS: Between 1982 and 2017, 164 patients with early-stage thymoma (Masaoka I and II) were operated on by median sternotomy (108 patients) or the robotic approach (56 patients)...
September 1, 2018: European Journal of Cardio-thoracic Surgery
Mario Dolera, Luca Malfassi, Nancy Carrara, Sara Finesso, Silvia Marcarini, Giovanni Mazza, Simone Pavesi, Massimo Sala, Gaetano Urso
Volumetric Modulated Arc Therapy (VMAT) is a modern technique, widely used in human radiotherapy, which allows a high dose to be delivered to tumor volumes and low doses to the surrounding organs at risk (OAR). Veterinary clinics takes advantage of this feature due to the small target volumes and distances between the target and the OAR. Sparing the OAR permits dose escalation, and hypofractionation regimens reduce the number of treatment sessions with a simpler manageability in the veterinary field. Multimodal volumes definition is mandatory for the small volumes involved and a positioning device precisely reproducible with a setup confirmation is needed before each session for avoiding missing the target...
January 24, 2018: Cancers
John K Peel, Eitan Prisman, Tony L Ng, Anna L McGuire
Ectopic thymoma in the neck is a rare phenomenon, with fewer than 20 cases reported worldwide. Evidence for management of ectopic thymoma comes from literature for mediastinal thymoma despite clinical features that distinguish the two. Here we present a case of a 31-year-old female with an asymptomatic neck mass who was found to have an ectopic cervical thymoma with concomitant mediastinal thymic hyperplasia. The decision was made to perform a left-sided neck dissection and a video-assisted thoracoscopic surgery (VATS) thymectomy...
December 2017: Journal of Thoracic Disease
Erkan Kaba, Berker Ozkan, Suat Erus, Salih Duman, Berk Cimenoglu, Alper Toker
PURPOSE: To analyze the role of surgery in patients with Masaoka stage IVa thymoma treated with multimodality therapy. METHODS: Of 191 patients undergoing surgery for thymoma in our department between January 2002 and December 2015, 39 (20.4%) had Masaoka stage IVa. Histopathological tumor type, myasthenic status of the Osserman-Genkins score, Masaoka stage at the first surgery, neoadjuvant treatment, number and type of surgeries, and survival rates were recorded...
February 20, 2018: Annals of Thoracic and Cardiovascular Surgery
Nicolas Girard
Thymic malignancies represent a heterogeneous group of rare thoracic cancers, which are classified according to the World Health Organization (WHO) histopathologic classification that distinguishes thymomas from thymic carcinomas and neuroendocrine tumors; neuroendocrine thymic tumors (NETTs) exhibit the same histological spectrum as in other anatomical locations, although with different frequencies. NETTs represent around 2% of all neuroendocrine tumors, and about 5% of all thymic malignancies. Overall, the management of patients with NETTs tumors requires continuous multidisciplinary expertise at any step of the disease progression...
November 2017: Journal of Thoracic Disease
Radmila Lemstrova, Veronika Brynychova, David J Hughes, Viktor Hlavac, Pavel Dvorak, Joanne E Doherty, Helena A Murray, Martin Crockard, Martin Oliverius, Jan Hlavsa, Eva Honsova, Jan Mazanec, Zdenek Kala, Martin Lovecek, Roman Havlik, Jiri Ehrmann, Ondrej Strouhal, Pavel Soucek, Bohuslav Melichar, Beatrice Mohelnikova-Duchonova
Pancreatic ductal adenocarcinoma (PDAC) is a tumor with a poor prognosis, and no targeted therapy is currently available. The aim of the present study was to investigate the prognostic significance of the expression of V-Ki-ras2 Κirsten rat sarcoma viral oncogene homolog (KRAS), downstream signaling pathway genes and the association with clinical characteristics in PDAC patients undergoing radical surgery. Tumors and adjacent non-neoplastic pancreatic tissues were examined in 45 patients with histologically verified PDAC...
November 2017: Oncology Letters
Marcin Zieliński
BACKGROUND: The minimally invasive thoracic procedures are those performed through the intercostal, subxiphoid, subcostal or transcervical incisions. In most of these procedures (with exception of some transcervical procedures) the video-assisted thoracic surgery (VATS) technique is used for performance of an operation under guidance of a video monitor. METHODS: According to the definition the minimally invasive procedures do not include the sternal manubriotomy (upper sternal split), transverse sternotomy and subcutaneous longitudinal sternotomy...
2017: Journal of Visualized Surgery
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