P25: VATS combined with a subxiphoid incision: a novel approach for large thymoma.

Abstract

In patients with thymoma larger than 5 cm in diameter, video-assisted thoracoscopic surgery (VATS) remains controversial as an approach for total thymectomy. Aside from the concerns such as possible rupture of tumor capsule, reduced safety margins and increased risk of local recurrence, how to remove specimen of this size from incisions of VATS is another problem that surgeons have to confront. We reported a case of a 47-year-old man who was referred to our department with a huge mass located on the anterior mediastinal and right hemithorax. After careful preoperative evaluation and planning, the tumor was completely removed by VATS and taken out of thoracic cavity through a subxiphoid incision. After resection, histologic analysis confirmed the diagnosis of thymoma B1 type. Postoperative course was uneventful and no adjuvant therapy was offered. The patient has continued to do well with no signs of recurrence at a follow-up of 10 months. We stress that VATS combined with a subxiphoid incision may be a useful surgical option for patients with thymoma larger than 5 cm in size.