Minimally invasive thymectomy for locally advanced recurrent thymoma

Abstract

Minimally invasive thymectomy for early stage thymoma patients has been shown to yield similar oncological results while being helpful in reducing surgical trauma, improving postoperative recovery, and diminishing incisional pain. However, patients with locally advanced tumors, preoperative induction therapies, or prior history of mediastinal surgery have been considered as not suitable for video-assisted thoracoscopic surgery (VATS). This video aims to show that VATS thymectomy may also be feasible in reoperation for recurrent invasive thymoma in selected cases. A 45-year-old female patient had recurrent type B2 thymoma in the anterior mediastinum 10 years after tumor resection through left thoracotomy. The lesion was in rcStage III. Reoperation was carried out via left approach VATS. The tumor was resected completely together with remnant thymus, pericardium, the left phrenic nerve, and the left innominate vein. The patient recovered uneventfully and was discharged on postoperative day 4. Pathologic study revealed an rpStage III type B tumor, invading the left phrenic nerve and the left innominate vein. VATS thymectomy may also be feasible in locally advanced thymic tumors or recurrent diseases. In selected cases, VATS should at least be tried so that this subgroup of patients may also benefit from minimally invasive surgery.