Surgical management of thymic cyst

Abstract

Objective To summarize our experience in patients with thymic cyst managed by surgical intervention. Methods From January 1990 to December 2013, 116 patients were diagnosed with thymic cyst and underwent surgical treatment at our hospital. There were 116 patients(52 males and 64 females). Median age was(58.9±7.1) years. Sixty patients underwent operation for a variety of symptoms, and 56 patients for the abnormal roentgenograms. The locations of the thymic cyst were 95 cases in the anterior mediastinum, 4 cases in the middle mediastinum and 4 cases extension from neck to anterior mediastinum, 9 cases in the anterior mediastinum and chest, 4 cases in the chest. Thoracic computerized tomography was performed in all the patients, which showed a unilocular or multilocular cyst with thin wall and uniform density. Preoperative diagnosis for the thymic cyst was made in 38 cases(32.8%). The operation was via a cervical incision in 10 cases, a video- assisted thoracoscopic surgery(VATS) in 61 cases(single port VATS in 12 cases, 2 ports VATS in 23 cases, 3 ports VATS in 26 cases), a median sternotomy in 15 cases, a lateral thoractomy in 29 cases, and a cervical incision with median sternotomy in 1 case. The operation were simple cyst resection in 67 cases, thymic cyst resection and thymectomy in 48 cases, and partial resection in 1 case, with lobectomy in 9 cases for the comorbidity of the other lung diseases. The postoperative pathology found thymic carcinoma in 2 cases. Results There was no operative death, and the operative complication occurred in 4 patients. The average operation time was(103.4±16.7) min, and the average blood loss was(118±45) ml. The postoperative hospital stay was(6.2±2.6) days on average. Follow-up was completd in 105 patients ranged from 6 to 48 months(median, 31.7 months). Two patients were deceased from lung cancer, and there were no recurrence or metastases for the other patients. Conclusion Our findings indicate that surgical resection can be used for the diagnosis and therapy of thymic cyst. The surgical incision should be chosen by the size and location of the thymic cyst. Key words: Mediastinal cyst; Thoracic surgical procedures; Thoracoscoy