Maximal Thymectomy via Mini Sternotomy with Pleural Preservation
Abstract Gaurav Patel Background There are different surgical techniques used for maximal thymectomy. Each technique has its own advantages and disadvantages. We propose a mini sternotomy with pleural...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2022-07-01
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| Series: | South Asian Journal of Cancer |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1743162 |
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| author | Gaurav Patel Bojja V. Kishore Reddy Prakash Patil |
| author_facet | Gaurav Patel Bojja V. Kishore Reddy Prakash Patil |
| author_sort | Gaurav Patel |
| collection | DOAJ |
| description | Abstract
Gaurav Patel
Background There are different surgical techniques used for maximal thymectomy. Each technique has its own advantages and disadvantages. We propose a mini sternotomy with pleural preservation approach for complete maximal thymectomy.
Methods Over time range of 5 years, 32 patients with diagnosis of thymoma with or without myasthenia gravis (MG) underwent maximal thymectomy by mini sternotomy in our institute. Patient records were examined for the following parameters: age, sex, preoperative medication, symptoms of MG as per Myasthenia Gravis Foundation of America grading system, operating time, duration of postoperative ventilation, length of stay in the intensive care unit, overall length of hospitalization, and postoperative complications.
Results The mean age of patients in our study was 43.66. Sex ratio in this study was almost equal. Sixty-nine percent of patients were stage I thymoma according to Masaoka staging. Size of the tumor ranged from 3 to 8 cm with mean size being 4.54 cm. Complete resection with negative tumor margins was possible in all the cases. Four patients had intraoperative pleural injury out of which two patients required intercostal tube insertion. We did not have any serious postoperative complications with no perioperative mortality.
Conclusions Mini sternotomy allows maximal removal of thymus through a less invasive approach and is associated with a significantly smoother postoperative course, less overall complications, and good clinical outcome. It is a simple technique that can be performed by any thoracic and surgical oncologists especially in Indian subcontinent where facilities of video-assisted thoracoscopic surgery and robotic video-assisted thoracoscopic surgery are not available in all areas and are expensive. |
| first_indexed | 2024-04-11T00:35:17Z |
| format | Article |
| id | doaj.art-d0d9cca0a8fe4774a41853221fd38c6f |
| institution | Directory Open Access Journal |
| issn | 2278-330X 2278-4306 |
| language | English |
| last_indexed | 2024-04-11T00:35:17Z |
| publishDate | 2022-07-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | South Asian Journal of Cancer |
| spelling | doaj.art-d0d9cca0a8fe4774a41853221fd38c6f2023-01-07T00:06:40ZengThieme Medical and Scientific Publishers Pvt. Ltd.South Asian Journal of Cancer2278-330X2278-43062022-07-01110322923410.1055/s-0042-1743162Maximal Thymectomy via Mini Sternotomy with Pleural PreservationGaurav Patel0Bojja V. Kishore Reddy1Prakash Patil2Department of Surgical Oncology, Bombay Hospital and Medical Research Centre, Marine Lines, Mumbai, Maharashtra, IndiaDepartment of Surgical Oncology, Bombay Hospital and Medical Research Centre, Marine Lines, Mumbai, Maharashtra, IndiaDepartment of Surgical Oncology, Bombay Hospital and Medical Research Centre, Marine Lines, Mumbai, Maharashtra, IndiaAbstract Gaurav Patel Background There are different surgical techniques used for maximal thymectomy. Each technique has its own advantages and disadvantages. We propose a mini sternotomy with pleural preservation approach for complete maximal thymectomy. Methods Over time range of 5 years, 32 patients with diagnosis of thymoma with or without myasthenia gravis (MG) underwent maximal thymectomy by mini sternotomy in our institute. Patient records were examined for the following parameters: age, sex, preoperative medication, symptoms of MG as per Myasthenia Gravis Foundation of America grading system, operating time, duration of postoperative ventilation, length of stay in the intensive care unit, overall length of hospitalization, and postoperative complications. Results The mean age of patients in our study was 43.66. Sex ratio in this study was almost equal. Sixty-nine percent of patients were stage I thymoma according to Masaoka staging. Size of the tumor ranged from 3 to 8 cm with mean size being 4.54 cm. Complete resection with negative tumor margins was possible in all the cases. Four patients had intraoperative pleural injury out of which two patients required intercostal tube insertion. We did not have any serious postoperative complications with no perioperative mortality. Conclusions Mini sternotomy allows maximal removal of thymus through a less invasive approach and is associated with a significantly smoother postoperative course, less overall complications, and good clinical outcome. It is a simple technique that can be performed by any thoracic and surgical oncologists especially in Indian subcontinent where facilities of video-assisted thoracoscopic surgery and robotic video-assisted thoracoscopic surgery are not available in all areas and are expensive.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1743162thymectomysternotomythymic neoplasm, thymomamyasthenia gravisthoracic surgery, video-assistedsurgery, robotic-assisted |
| spellingShingle | Gaurav Patel Bojja V. Kishore Reddy Prakash Patil Maximal Thymectomy via Mini Sternotomy with Pleural Preservation South Asian Journal of Cancer thymectomy sternotomy thymic neoplasm, thymoma myasthenia gravis thoracic surgery, video-assisted surgery, robotic-assisted |
| title | Maximal Thymectomy via Mini Sternotomy with Pleural Preservation |
| title_full | Maximal Thymectomy via Mini Sternotomy with Pleural Preservation |
| title_fullStr | Maximal Thymectomy via Mini Sternotomy with Pleural Preservation |
| title_full_unstemmed | Maximal Thymectomy via Mini Sternotomy with Pleural Preservation |
| title_short | Maximal Thymectomy via Mini Sternotomy with Pleural Preservation |
| title_sort | maximal thymectomy via mini sternotomy with pleural preservation |
| topic | thymectomy sternotomy thymic neoplasm, thymoma myasthenia gravis thoracic surgery, video-assisted surgery, robotic-assisted |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1743162 |
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