Standardized definitions and policies of minimally invasive thymoma resection

Comparing the safety and efficacy of thoracoscopic surgery and thoracotomy for thymoma: a systematic review and meta-analysis

BACKGROUND

To systematically evaluate the efficacy of thoracoscopic surgery compared to traditional thoracotomy for thymic tumors.

METHODS

We performed a literature search on computer of the PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine (CBM), WanFang, and China national knowledge infrastructure (CNKI) databases from the date of establishment of the database to April 2021, and retrieved randomized controlled trials (RCTs) and cohort studies on thoracoscopic surgery and thoracotomy with conventional open thoracic surgery. After independent screening of the literature by two assessors, the relevant data was extracted and the risk of bias in the included studies was evaluated. RevMan 5.3 software was used to perform the analysis.

RESULTS

Five RCTs and eight cohort studies were ultimately included, with a total of 1,093 patients. The results of meta-analysis showed that compared with traditional thoracoscopic surgery, thoracoscopy had shorter surgery duration (OR =22.2, 95% CI: -31.92, -12.52, P<0.00001), ICU stay (OR =0.29, 95% CI: 0.20, 0.42, P<0.00001), and hospitalization time (OR =0.531, 95% CI: 0.41, 0.69, P<0.00001) times, as well as reduced chest tube drainage time (OR =0.49, 95% CI: 0.33, 0.73, P=0.0004), less intraoperative bleeding (OR =43.27, 95% CI: -50.94, -35.60, P<0.00001), and a lower incidence of postoperative complications (OR =0.19, 95% CI: 0.11, 0.34, P<0.00001). However, the tumor recurrence rate was not significantly different between the two procedures (OR =0.69, 95% CI: 0.32, 1.48, P=0.34).

DISCUSSION

The existing evidence suggests that thoracoscopic surgery has shorter surgery duration, ICU stay time, hospitalization time, reduced thoracic tube drainage, less intraoperative bleeding, and a lower incidence of postoperative complications compared with traditional thoracotomy surgery. However, due to the poor quality of the included research, more high-quality studies need to be conducted to verify the above conclusions.

Thymic minimally invasive surgery: state of the art across the world-Europe

In this brief review of selected peer-reviewed literature on thymic minimally-invasive surgery (MIS) we sought to identify if there is a unique approach to thymic MIS on the European continent.

Video-assisted and minimally-invasive open chest surgery for the treatment of mediastinal tumors and masses

This article reviews the anatomy of the mediastinum as well as indications, limitations, techniques, and results of video-assisted thoracic surgery (VATS) and other minimally-invasive open-chest surgery approaches currently used for the surgical management of mediastinal tumors and masses. It is written by two surgeons with vastly different backgrounds and thoracic surgical experience. One of them is young and very familiar with VATS approaches and technologies while the other is a senior surgeon relatively unfamiliar with minimally-invasive techniques. This combination of authorship is ideal to analyze the pros and cons of the use of minimally-invasive approaches for the surgical management of mediastinal lesions such as thymic epithelial tumors (TETs) or neurogenic tumors. This is important because several thoracic surgeons have expressed concerns about the ability of thoracoscopic procedures to maintain adherence to sound oncological principles.