Surgical Outcomes of VATS Versus Open Approaches in Thymic Epithelial Tumors: A Retrospective Single-Center Study

Yıl 2026, Cilt: 8 Sayı: 1, 147 - 155, 28.02.2026

Hacer Boztepe Yeşilçay , Şencan Akdağ

https://doi.org/10.52827/hititmedj.1832231

https://izlik.org/JA98WF78LS

Öz

Objective: Thymic epithelial tumors (TETs) are rare and heterogeneous neoplasms located in the anterior mediastinum, and surgical resection remains the most significant prognostic determinant of survival. The aim of this study was to evaluate the perioperative and oncologic outcomes of patients with TET according to radiologic and clinical staging, comparing two surgical approaches: video-assisted thoracoscopic surgery (VATS) and open surgery.
Material and Method: Medical records of 36 patients who underwent surgery for pathologically confirmed TET between June 2013 and December 2020 were reviewed retrospectively. Patients were divided into two groups based on the surgical technique employed: VATS (n=22) and open surgery (n=14). Demographic characteristics, tumor diameter, Masaoka staging, histopathological subtype, duration of drainage, length of hospital stay, postoperative complications, and recurrence rates were analyzed.
Results: The mean tumor diameter was 3.58 ± 0.24 cm in the VATS group and 7.34 ± 0.33 cm in the open surgery group (p<0.001). The mean drainage duration and hospital stay were significantly shorter in the VATS group (2.31 ± 0.22 days and 3.68 ± 0.39 days, respectively) compared with the open surgery group (both p<0.001). The proportion of Masaoka stage I disease was significantly higher in the VATS cohort (p<0.05). Postoperative complications were observed exclusively in the open surgery group. During follow-up, recurrence occurred in 1 patient in the VATS group and in 2 patients in the open surgery group.
Conclusion: When appropriate patient selection and staging are applied, minimally invasive surgery represents a safe and effective treatment modality for TET. VATS offers advantages such as reduced morbidity and shorter hospitalization in early-stage disease, while maintaining oncologic outcomes comparable to open surgery.

Anahtar Kelimeler

Thymic epithelial tumor , VATS , minimally invasive surgery , Masaoka staging , myasthenia gravis.

Timik Epitelyal Tümörlerde VATS ve Açık Yaklaşımların Cerrahi Sonuçları: Retrospektif Tek Merkezli Bir Çalışma

https://izlik.org/JA98WF78LS

Öz

Amaç: Timik epitelyal tümörler (TET), nadir görülen ve anterior mediastende yerleşim gösteren heterojen neoplazmlardır. Cerrahi rezeksiyon, sağkalım üzerinde belirleyici olan başlıca prognostik faktördür. Bu çalışmanın amacı, TET tanılı hastalarda radyolojik ve klinik evrelemeye göre tercih edilen cerrahi yaklaşımın (VATS vs. açık cerrahi) perioperatif sonuçlar ve uzun dönem onkolojik sonuçlar üzerindeki etkilerini değerlendirmektir.
Gereç ve Yöntem: Haziran 2013 – Aralık 2020 tarihleri arasında kliniğimizde opere edilen ve histopatolojik tanısı TET olan 36 hastanın kayıtları retrospektif olarak analiz edildi. Hastalar uygulanan cerrahi teknik esas alınarak VATS (n=22) ve açık cerrahi (n=14) olmak üzere iki gruba ayrıldı. Demografik özellikler, tümör boyutu, Masaoka evresi, histopatolojik alt tip, drenaj süresi, hastanede kalış süresi, postoperatif komplikasyonlar ve nüks oranları karşılaştırıldı.
Bulgular: Ortalama tümör çapı VATS grubunda 3,58 ± 0,24 cm iken açık cerrahi grubunda 7,34 ± 0,33 cm idi (p<0,001). Ortalama drenaj süresi ve hastanede kalış süresi VATS ile opere edilen hastalarda sırasıyla 2,31 ± 0,22 gün ve 3,68 ± 0,39 gün olup açık cerrahi grubuna kıyasla anlamlı derecede daha kısaydı (her ikisi için p<0,001). Masaoka evre I hastalık oranı VATS grubunda belirgin olarak yüksekti (p<0,05). Postoperatif komplikasyon yalnızca açık cerrahi grubunda görüldü. Takip sürecinde VATS grubunda 1, açık cerrahi grubunda ise 2 hastada nüks gelişti.
Sonuç: Minimal invaziv yaklaşım, uygun evreleme ve hasta seçimi ile TET cerrahisinde güvenli ve etkili bir yöntemdir. VATS, erken evre olgularda daha düşük morbidite ve daha kısa hastanede yatış süresi gibi avantajlar sunmakta; onkolojik sonuçlar açısından ise açık cerrahi ile karşılaştırılabilir performans göstermektedir.

Anahtar Kelimeler

Timik epitelyal tümör , VATS , minimal invaziv cerrahi , Masaoka evreleme , myastenia gravis.

Kaynakça

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