EFFECTIVENESS OF SURGICAL TREATMENT OF THYMIC TUMORS: MINIMALLY INVASIVE VIDEO-ASSISTED THORACOSCOPIC AND OPEN THYMECTOMY

Abstract

The adoption of thoracoscopic methods for the treatment of thymic tumors has been slow, due to the unique
characteristics of tumors in this location and the technical challenges of operating within the anatomically confined mediastinal space, which contains numerous vital structures. Data on the outcomes of minimally invasive video-assisted thoracoscopic surgery (VATS) thymectomy in Lithuanian clinical centers are scarce. Here, we present an analysis of thymectomy cases performed at the Heart Centre of the Lithuanian University of Health Sciences between 2010 and 2025. Objective. To evaluate the effectiveness of surgical approaches in the treatment of thymic tumors by comparing minimally invasive video assisted thoracoscopic (VATS) thymectomy with open thymectomy. Methods. A retrospective analysis was conducted on 92 patients treated for thymoma or other thymic pathologies at the Department of Thoracic Surgery, Hospital of the Lithuanian University of Health Sciences Kauno Clinics, between 2010 and 2025. Results. The mean age of the patients was 56.8 ± 14.6 years, with an equal distribution of males and females (50.0% each). VATS thymectomy was performed in 41 (44.5%) patients, thoracotomy in 40 (43.5%), and sternotomy in 11 (12.0%) patients. The most common histological diagnoses were thymic carcinoma (33.3%) and type AB thymoma (14.4%). No statistically significant association was found between the surgical approach and histological diagnosis (p = 0.383), nor between surgical methods when comparing operative time and intraoperative blood loss (p > 0.05). In the VATS group, postoperative hospital stay was significantly shorter compared ton the thoracotomy group (median 7.0 vs 10.5 days, p = 0.004), with a median difference of 3.5 days. The duration of pleural drainage was also significantly shorter after VATS compared to open thoracotomy (median 5.0 vs 8.0 days, p = 0.0021), with a median difference of 3 days. Conclusions.VATS for the treatment of thymic tumors is associated with a significantly shorter duration of pleural drainage and postoperative hospital stay compared to open thoracotomy. These findings suggest faster postoperative recovery and reduced surgical trauma. In contrast, operative time and intraoperative blood loss did not differ significantly between the surgical approaches.