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Reconstruction of mediastinal vessels for invasive thymoma: a retrospective analysis of 25 cases.

Abstract：

BACKGROUND:Discuss an appropriate strategy for treatment of invasive thymoma invading adjacent great vessels. METHODS:A retrospective study on 25 patients with invasive thymoma invading neighboring great vessels was performed. The corresponding data including clinical presentation, operation procedure, adjuvant radio-chemotherapy and follow-up were reviewed. RESULTS:Twenty of 25 (80%) patients with invasive thymoma underwent complete resection of the tumor along with vessel reconstruction. Intraoperatively, different types of operation were conducted, namely, brachiocephalic vein (BCV)-right atrial appendage (RAA) reconstruction in 11 cases, complex vessel reconstruction (more than one graft) in 1 case and superior vena cava (SVC)-SVC reconstruction in the remaining cases. Ringed polytetrafluoroethylene (PTFE) grafts were used for vessel reconstruction. Postoperatively, three cases suffered from pulmonary infection, and three cases had haemothorax, chylothorax and atelectasis, respectively. Two patients died due to acute respiratory distress syndrome within 90 days after the surgery. Within the remaining patients, 11 cases (44%) experienced a relapse and finally 8 (32%) patients died. Compared to R1 resection group, R0 resection group had a better prognosis (Log-rank P=0.0196). The 3- and 5-year survival rates were 79.6% and 59.1%, with median survival time of 84 months. CONCLUSIONS:Reconstruction of mediastinal vessels for invasive thymoma is a feasible technology method. Radical resection of the tumor with involved neighboring structures is the key to prolong overall survival for patients suffered from invasive thymoma.

journal_name

J Thorac Dis

journal_title

Journal of thoracic disease

authors

Sun Y,Gu C,Shi J,Fang W,Luo Q,Hu D,Fu S,Pan X,Chen Y,Yang Y,Yang H,Zhao H,Chen H

doi

10.21037/jtd.2017.03.03

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

725-733

issue

3

eissn

2072-1439

issn

2077-6624

pii

jtd-09-03-725

journal_volume

9

pub_type

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