Abstract

Standard resection for patients with thymoma is resection of thymoma with total thymectomy (TTx) via median sternotomy. Hence, limited resection for thymoma means a lesser extent of resection of normal thymus compared with a standard procedure, i.e. resection of thymoma with partial thymectomy (PTx). In contrast, minimally invasive resection has been defined as resection of thymoma with TTx via a less-invasive approach. However, to date, few studies have precisely evaluated the differences in surgical and oncological outcomes among these three procedures. This report summarizes the differences among these three procedures with a review of studies (January 2000 to December 2020) focusing on the difference in surgical and oncological outcomes and presents current issues in the surgical management of thymoma. In this report, 16 studies were identified; 5 compared standard resection to limited resection, 9 compared standard resection to minimally invasive resection and 2 compared limited resection to minimally invasive resection. Most studies reported that the surgical and oncological outcomes of limited resection or minimally invasive resection were similar to those of standard resection in patients with early-stage thymoma. However, they did not include a sufficient follow-up period. Both limited resection and minimally invasive resection for early-stage thymoma might be reasonable treatment options. However, they are still promising modes of resection. Further studies with a long follow-up period are needed.

中文翻译：

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早期胸腺瘤的有限切除：微创切除并不意味着有限切除

摘要

胸腺瘤患者的标准切除术是通过胸骨正中切开术用全胸腺切除术 (TTx) 切除胸腺瘤。因此，与标准程序相比，胸腺瘤的有限切除意味着正常胸腺的切除程度更小，即切除胸腺瘤和部分胸腺切除术 (PTx)。相比之下，微创切除被定义为通过微创方法用 TTx 切除胸腺瘤。然而，迄今为止，很少有研究准确评估这三种手术在手术和肿瘤学结果上的差异。本报告通过回顾研究（2000 年 1 月至 2020 年 12 月）总结了这三种手术之间的差异，重点关注手术和肿瘤学结果的差异，并提出了胸腺瘤手术治疗的当前问题。在这份报告中，确定了 16 项研究；5 人比较了标准切除与有限切除，9 人将标准切除与微创切除进行了比较，2 人将有限切除与微创切除进行了比较。大多数研究报告，早期胸腺瘤患者有限切除或微创切除的手术和肿瘤学结果与标准切除相似。然而，它们没有包括足够的随访期。早期胸腺瘤的有限切除和微创切除都可能是合理的治疗选择。然而，它们仍然是有希望的切除方式。需要长期随访的进一步研究。9 比较标准切除和微创切除，2 比较有限切除和微创切除。大多数研究报告，早期胸腺瘤患者有限切除或微创切除的手术和肿瘤学结果与标准切除相似。然而，它们没有包括足够的随访期。早期胸腺瘤的有限切除和微创切除都可能是合理的治疗选择。然而，它们仍然是有希望的切除方式。需要长期随访的进一步研究。9 比较标准切除和微创切除，2 比较有限切除和微创切除。大多数研究报告，早期胸腺瘤患者有限切除或微创切除的手术和肿瘤学结果与标准切除相似。然而，它们没有包括足够的随访期。早期胸腺瘤的有限切除和微创切除都可能是合理的治疗选择。然而，它们仍然是有前途的切除方式。需要长期随访的进一步研究。它们没有包括足够的随访期。早期胸腺瘤的有限切除和微创切除都可能是合理的治疗选择。然而，它们仍然是有希望的切除方式。需要长期随访的进一步研究。它们没有包括足够的随访期。早期胸腺瘤的有限切除和微创切除都可能是合理的治疗选择。然而，它们仍然是有希望的切除方式。需要长期随访的进一步研究。