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Ann Thorac Surg 2004;77:1878
© 2004 The Society of Thoracic Surgeons

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Correspondence

Video-assisted extended thymectomy in patients with thymoma by lifting the sternum: is it safe? Reply

Department of Thoracic Surgery, National Kyushu Medical Center, Clinical Research Institute Jigyohama 1-8-1 Chuo-ku Fukuoka 810-8563, Japan

e-mail: sada{at}qmed.hosp.go.jp

To the Editor:

I do not agree with Dr Aubert and colleagues' conclusion that video thoracoscopy (VT) thymic biopsy and VT thymectomy are dangerous and should not be performed for well-encapsulated thymic tumors. However, I do agree that cancer resection must be performed through incisions that provide good exposure (median sternotomy).

Twelve patients underwent thoracoscopic extended thymectomy with sternal lifting at our institution between 1998 and 2002. The thoracoscopic procedure was uneventful in all 12 patients; no patient required conversion to open thoracotomy. Histologic examination confirmed that 9 were thymoma of Masaoka's stage I and 1 was stage III. There were also one case each of malignant lymphoma and thymic carcinoid. Although no postoperative deaths or major complications occurred, two patients had minor complications. During a mean surveillance period of 39.2 months (range, 10 to 53 months), there was no recurrence in any of the patients. Consequently, there was no chest wall implantation and no recurrence at the port sites. Moreover, we usually performed VT thymic biopsy for well-encapsulated thymic tumors, since conversion to median sternotomy was performed immediately for malignant tumors beginning in 2000. However, there was no recurrence at the port sites in any patient. When we perform VT thymic biopsy or lung biopsy, the biopsy needle is inserted through a 5.5-mm port, and we take care so that it does not touch inside or outside the port.

We believe that our method of VT thymectomy gives results that are comparable to those achieved by thoracotomy and that VT biopsy and VT thymectomy are not dangerous.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Takeo, S. Search for Related Content PubMed Articles by Takeo, S. Related Collections Esophagus - cancer