• Yasushi Sakamaki, Tomofumi Oda, Go Kanazawa, Toshio Shimokawa, Tetsuo Kido, and Hiroyuki Shiono.
• Department of Chest Surgery, Osaka Police Hospital, Osaka, Japan. Electronic address: sak@serenade.plala.or.jp.
• J. Thorac. Cardiovasc. Surg.. 2014 Oct 1;148(4):1230-1237.e1.

ObjectiveTo evaluate the impact on patient survival of video-assisted thoracoscopic surgery (VATS) thymectomy for the treatment of early-stage thymoma, by comparing the intermediate-term oncologic outcomes with outcomes after open thymectomy.MethodsEighty-two patients who underwent complete resection of a Masaoka stage I or II thymoma between November 1998 and December 2011 were reviewed.ResultsThe patients included 32 men and 50 women (median age, 57 years; range, 20-90 years), of whom 44 had stage I thymoma and 38 had stage II thymoma. Seventy-one patients underwent VATS, of whom 4 (5.6%) underwent conversion to open thymectomy; the remaining 11 patients underwent planned open thymectomy. Thirty-six patients underwent total thymectomy and 46 underwent partial thymectomy. Operative mortality was nil. The tumor stage, tumor size, and proportion of patients who underwent total thymectomy were not significantly different between the open and VATS thymectomy groups. The median follow-up period was 49 months (VATS, 48 months; open, 52 months). There was a significant difference between the 2 groups for the estimated 5-year overall survival (VATS, 97.0%; open, 79.5%; P=.041) but not in the estimated 5-year recurrence-free survival.ConclusionsOur findings indicate that the intermediate-term oncologic outcomes after VATS thymectomy for early-stage thymoma are as favorable as outcomes after open thymectomy. Further follow-up is still required to evaluate the long-term outcomes after VATS thymectomy.Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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