Abstract
Background Thoracoscopic thymectomy is increasingly performed for the treatment of early stage
thymoma. It is characterized by shorter postoperative hospital stay, decreased intraoperative
blood loss, and fewer complications compared with transsternal thymectomy. Unilateral
video-assisted thoracic surgery (VATS) thymectomy can be easily performed from either
side of the thorax, because thymus is located in the middle of mediastinum. However,
the side that provides better outcomes remains controversial. The purpose of this
study was to compare the efficacy of right and left approaches in performing unilateral
thoracoscopic thymectomy for thymoma.
Methods Consecutive patients affected by thymoma who underwent VATS thymectomy on either
side between February 2001 and March 2020 were enrolled in the study. Clinicopathologic,
surgical, and oncological outcomes were retrospectively analyzed and compared among
the two surgical approaches.
Results Unilateral VATS approaches were performed on 29 patients: 12 (41%) on the left side
and 17 (59%) on the right side. The mean age was 63.1 ± 11.3 years and the female/male
ratio was 1.73:1. The mean operative time and the hospital stay for the left-side
VATS and right-side VATS groups were, respectively, 168 ± 49.5 versus 171 ± 47.9 minutes
(p = 0.9) and 3 ± 1.03 days versus 3.65 ± 1.93 days (p = 0.7). Postoperative complications occurred in one patient (3%) for left-side VATS
group and one patient (3%) for right-side VATS. The 5-year disease-free survival was
comparable between two groups (p = 0.74).
Conclusion Unilateral VATS thymectomy in patients with thymoma can be safely and effectively
performed by experienced surgeons in either side of the thorax with equivalent oncological
outcomes.
Keywords
myasthenia gravis - VATS - thymectomy - outcomes - thymoma
