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Bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report
BACKGROUND: Video-assisted thoracoscopy is become a widely accepted approach for the resection of anterior mediastinal masses, including thymoma. The current trend is to reduce the number of ports and minimize the length of incisions to further decrease postoperative pain, chest wall paresthesia, an...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120463/ https://www.ncbi.nlm.nih.gov/pubmed/27876071 http://dx.doi.org/10.1186/s13019-016-0547-3 |
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author | Caronia, Francesco Paolo Fiorelli, Alfonso Arrigo, Ettore Trovato, Sebastiano Santini, Mario Monte, Attilio Ignazio Lo |
author_facet | Caronia, Francesco Paolo Fiorelli, Alfonso Arrigo, Ettore Trovato, Sebastiano Santini, Mario Monte, Attilio Ignazio Lo |
author_sort | Caronia, Francesco Paolo |
collection | PubMed |
description | BACKGROUND: Video-assisted thoracoscopy is become a widely accepted approach for the resection of anterior mediastinal masses, including thymoma. The current trend is to reduce the number of ports and minimize the length of incisions to further decrease postoperative pain, chest wall paresthesia, and length of hospitalization. Herein, we reported an extended resection of thymoma in a patient with myasthenia gravis through an uniportal bilateral thoracoscopic approach. CASE PRESENTATION: A 74 years old woman with myasthenia gravis was referred to our attention for management of a 3.5 cm, well capsulate, thymoma. All laboratory and cardio-pulmonary tests were within normal; thus, she was scheduled for thymoma resection through an uniportal bilateral thoracoscopic approach. Under general anaesthesia and selective intubation, the patient was placed in a 60° right lateral decubitus. A 3 cm skin incision was performed in the fourth right intercostal space and, through that a 30° video-camera and working instruments were inserted without rib spreading. After complete dissection of the thymus and mediastinal fat, the contralateral pleura was opened, and, through that the specimen was pushed into the left pleural cavity. Then, the patient was placed in the left lateral decubitus. Similarly to the right side procedure, a 3-cm incision was performed in the fourth left intercostal space to complete thymic dissection and retrieve the specimen. No intraoperative and post-operative complications were found. The patient was discharged four days later. Pathological examination revealed a type A thymoma (Masaoka stage I). No recurrence was found at 18 months of follow-up CONCLUSIONS: Bilateral single-port thoracoscopy is an available procedure for management of thymoma associated with myasthenia gravis. The less post-operative pain, the reduction of hospital stay and the better esthetic results are all potential advantages of this approach over traditional technique. Obviously, our impression should be validated by larger studies in terms of long-term oncological outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13019-016-0547-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5120463 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-51204632016-11-28 Bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report Caronia, Francesco Paolo Fiorelli, Alfonso Arrigo, Ettore Trovato, Sebastiano Santini, Mario Monte, Attilio Ignazio Lo J Cardiothorac Surg Case Report BACKGROUND: Video-assisted thoracoscopy is become a widely accepted approach for the resection of anterior mediastinal masses, including thymoma. The current trend is to reduce the number of ports and minimize the length of incisions to further decrease postoperative pain, chest wall paresthesia, and length of hospitalization. Herein, we reported an extended resection of thymoma in a patient with myasthenia gravis through an uniportal bilateral thoracoscopic approach. CASE PRESENTATION: A 74 years old woman with myasthenia gravis was referred to our attention for management of a 3.5 cm, well capsulate, thymoma. All laboratory and cardio-pulmonary tests were within normal; thus, she was scheduled for thymoma resection through an uniportal bilateral thoracoscopic approach. Under general anaesthesia and selective intubation, the patient was placed in a 60° right lateral decubitus. A 3 cm skin incision was performed in the fourth right intercostal space and, through that a 30° video-camera and working instruments were inserted without rib spreading. After complete dissection of the thymus and mediastinal fat, the contralateral pleura was opened, and, through that the specimen was pushed into the left pleural cavity. Then, the patient was placed in the left lateral decubitus. Similarly to the right side procedure, a 3-cm incision was performed in the fourth left intercostal space to complete thymic dissection and retrieve the specimen. No intraoperative and post-operative complications were found. The patient was discharged four days later. Pathological examination revealed a type A thymoma (Masaoka stage I). No recurrence was found at 18 months of follow-up CONCLUSIONS: Bilateral single-port thoracoscopy is an available procedure for management of thymoma associated with myasthenia gravis. The less post-operative pain, the reduction of hospital stay and the better esthetic results are all potential advantages of this approach over traditional technique. Obviously, our impression should be validated by larger studies in terms of long-term oncological outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13019-016-0547-3) contains supplementary material, which is available to authorized users. BioMed Central 2016-11-22 /pmc/articles/PMC5120463/ /pubmed/27876071 http://dx.doi.org/10.1186/s13019-016-0547-3 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Caronia, Francesco Paolo Fiorelli, Alfonso Arrigo, Ettore Trovato, Sebastiano Santini, Mario Monte, Attilio Ignazio Lo Bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report |
title | Bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report |
title_full | Bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report |
title_fullStr | Bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report |
title_full_unstemmed | Bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report |
title_short | Bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report |
title_sort | bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120463/ https://www.ncbi.nlm.nih.gov/pubmed/27876071 http://dx.doi.org/10.1186/s13019-016-0547-3 |
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