Background: To explore the feasibility and efficacy of thoracoscopic radical resection of huge retrosternal thymoma using artificial pneumothorax.
Methods: A retrospective analysis was performed on 19 patients with bulky thymoma who underwent thoracoscopic resection using artificial pneumothorax by CO2 insufflation.
Results: The operations were performed with unilateral or bilateral thoracic incisions via single lumen endotracheal intubation and two-lung ventilation. And this approach provided excellent exposure of the thoracic cavity and reliable control of the neuro-vascular structures in the anterior mediastinum, which was of vital importance for extended resection of malignant thymoma. Besides, the operation time was 140.0±51.4 min without conversion to thoracotomy or sternotomy. And the pathological diagnosis was confirmed by immunohistochemistry, including 5 cases of thymus lipomyoma, 1 case of thymus hyperplasia, 1 case of thymus cyst, 2 cases of type AB thymoma, 4 cases of type B1 thymoma, 4 cases of type B3 thymoma, and 2 cases of thymic carcinoma. Furthermore, there were no complications such as recurrent laryngeal nerve injury, phrenic nerve injury, pulmonary infection or atelectasis, with hospital stay of 5.0±3.0 d.
Conclusions: Thoracoscopic resection of thymoma using artificial pneumothorax is a preferable approach, which could be considered for patients with bulky retrosternal tumors.
