REVIEW SOME CLINICAL CHARACTERISTICS, COMPUTED TOMOGRAPHY IMAGING FEATURES AND HISTOLOGY OF PATIENTS WITH THYMOMA UNDERWENT THYMECTOMY BY ROBOTIC ASSISTED THORACOSCOPIC SURGERY AT CHO RAY HOSPITAL

Đình Minh Thanh Đặng, Hữu Vĩnh Vũ, Văn Nam Nguyễn

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Abstract

Objectives: To comment some clinical chracteristics, computed tomography imaging features and histology of patients with thymoma underwent thymectomy by robotic assisted thoracoscopic surgery. Patients and methods: Patients with thymoma underwent thymectomy by robotic assisted thoracoscopic surgery from 1/2020 to 12/2023 at Cho Ray hospital. Results: The ratio of female and male was 1.39 :1, the mean age was 49.42 ± 13.46 (range, 17 -72 years). Nineteen patients (44.2%) were affected by myasthenia gravis. Preoperative Perlo – Osserman class was I in 4 patients, IIA in 11 patients and IIB in 4 patients. Tumor size ≥ 5cm  was in 22 patients (51.2%) and < 5cm was in 21 patients (48.8%), the mean diameter of the resected tumors was 5.08cm. The proportion of central tumor was highest (48.8%), the right side (20,8%) and the left side (30.2%). The enhanced degree was mainly medium or high (72.1%), there was only 2 patients (4.65%) with foci and 1 patient with invasion to surround organs. World Health Organization histology was lipothymoma (14%), type A (16.3%), type AB (30.2%), type B1 (9.3%), type B2 (20.9%), type B3 (4.7%) and thymic carcinoma (4.7%). Masaoka stage I (41,9%), IIA (34.9%), IIB (11.6%) and III (11.6%). There was relation between histology, Masaoka stage and contrast-enhanced degree on chest CT scans. Conclusion: The mean diameter of resected tumors in patients with thymoma underwent thymectomy by robotic assisted thoracoscopic surgery was 5.08cm, the majority was early stage (Massaoka I and II). The higher tumors have risk of malignancy, the higher were contrast-enhanced degree and the later Masaoka.

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References

Cheng Y.J., Hsu J.S. and Kao E.K. (2007). Characteristicsof thymoma successfully resected by videothoracoscopic surgery. Sringer., 37: 192-196.
2. Mao Z.F., Mo X.A., Qin C., et al. 2012. Incidence of thymoma in myasthenia gravis: a systematic review. J Clin Neurol., 8(3):161-169.
3. Marulli G., Maessen J., Melfi F. et al. 2016. Multi-institutional European experience of robotic thymectomy for thymoma. Ann Cardiothoracic Surg., 5(1):18-25.
4. Weng W., Li ., Meng S. et al. 2019. Video assited thoracoscopic thymectomy is feasile for large thymomas: a propensity-matched and comparison. Interactive CardioVascular and Thoracic surgery., 30: 565-572.
5. Lê Việt Anh. (2019). Nghiên cứu ứng dụng phẫu thuật nội soi lồng ngực cắt u tuyến ức điều trị bệnh nhược cơ tại bệnh viện Quân y 103. Luận án tiến sĩ y học, Học viện Quân y.
6. Tian W., Li X., Tong H., et al. 2020. Surgical effect and prognostic factors of myasthenia gravis with thymoma. Thoracic cancer., 11: 1288-1296.
7. Osserman K. E. and Genkins G. 1971. Studies in myasthenia gravis: review of a twenty-year experience in over 1200 patients. Mt Sinai J Med. 38(6): 497-537.
8. Quian L., Chen X., Huang J., et al. 2017. A comparison of three approaches for the treatment of early stage thymomas: robot-assisted thoracic surgery, video-assisted thoracic surgery, and median sternotomy. Journal of Thoracic Disease., 9(7): 1997-2005.
9. Han X., Gao W., Chen Y., et al. 2019. Relationship between computed tomography imaging features and clinical characteristics, Masaoka-Koga stages, and World Health Organization histological classifications of thymoma. Frontiers in Oncology., 9: 1-13.
10. Marx A., Chan K.C., Coindre J.M., et al. 2015. The 2015 World Health Organization classification of tumors of the thymus: Continuity and changes. J Thorac Oncol., 10(10): p. 1383-1395.