Videothoracoscopic resection of encapsulated thymic carcinoma: Retrospective comparison of the results between thoracoscopy and open methods

Background: Although videothoracoscopic (VTS) resection of thymoma has been reported to be a less invasive technique than open sternotomy, the usefulness of this method in the treatment of encapsulated thymic carcinoma has not yet been evaluated. We retrospectively compared the VTS and open methods (median sternotomy) to investigate whether VTS resection could be performed as successfully as open surgery to treat resectable thymic carcinoma. Methods: Between November 2002 and March 2007 a retrospective review was made of eight patients (four women and four men) with Masaoka stage I and II encapsulated thymic tumor. Four patients (the VTS group) underwent tumor resection by means of a three-port endoscopic technique. The other four patients (the open group) underwent tumor excision via a standard sternotomy approach. The resected thymic carcinoma tissues were all confirmed by histopathological examination. Results: No patient died nor did any major morbidity or recurrence occur during the mean follow-up period of 3.76 +/- 1.43 years. The open group sustained more blood loss (246.3 ml more) and pleural drainage time (5.7 days more), and were hospitalized for a longer period (12.5 days more). However in the open group the tumor size was larger (38.6 cm(3) more ) and the mean follow-up time was longer (1.4 years more). Conclusion: These results have encouraged us to treat more patients with encapsulated thymic carcinoma by means of VTS resection.