Eastern Cardiothoracic Surgical Society

Single Institution Experience with Uniportal VATS Thymectomy for Thymic Disease
Stevan S. Pupovac, Paul C. Lee, Lawrence Glassman, Kevin Hyman, David Zeltsman, Northwell Health, New Hyde Park, NY


OBJECTIVE: Over the last two decades, the unremitting development and refinement of minimally invasive approaches in thoracic surgery resulted in video-assisted thoracic surgery (VATS) becoming the preferred and standard operation for thymic disease. Among numerous benefits, VATS thymectomy has been shown to decrease the duration of hospital stay, reduce postoperative pain, provide an earlier return to daily activities and provide better cosmesis, when compared to previous approaches. Herein, we present one of the largest published series of uniportal VATS thymectomy, showing delicate and complete anterior mediastinal resections are both safe and reliable.

METHODS: Between January 2010 and July 2016, thirty-two patients who underwent uniportal VATS thymectomy at our institution were reviewed. Intraoperative data such as blood loss, complications and conversion to open surgery was reviewed. Postoperative outcomes such as duration of hospital stay, pleural drainage and chest tube duration were reviewed from the hospital charts.

RESULTS: Nineteen women and thirteen men with a mean age of 56 14.2 years had a uniportal VATS thymectomy. There were no complications and no conversions to open surgery. Intraoperative blood loss was minimal (16 7.0 mL), average chest tube duration and postoperative hospital stay were 1.2 0.5 days.

CONCLUSIONS: It is our experience that uniportal VATS thymectomy is safe, technically feasible and reliable and is the most minimally invasive option for the surgical management of thymic pathology.