Endovideosurgical removal of ectopic thymoma

Abstract

A clinical case of endovascular surgical removal of ectopic thymoma in the hospital surgery clinic of S. M. Kirov Military Medical Academy performed a planned surgical intervention - thymomtectomy from left-side thoracoscopic access. 4 thoracoports used. The time of surgical intervention was 125 minutes, the volume of intraoperative blood loss was less than 50 ml. The postoperative period was uneventful. Drainage removed the next day. There were no postoperative complications. Discharged on the 5th day of the postoperative period in satisfactory condition. It is believed that ectopic thymomas arise from scattered ectopic thymus tissue, which could not migrate to the anteroposterior mediastinum. Currently, the surgical method is the «gold standard» in the treatment of patients with thymus neoplasms. Complete surgical removal of the thymus gland is a prerequisite for the effective treatment of thymic tumors. The basic principle of radicalism is the complete excision of the tumor surrounding the tissue with the lymph nodes. Particular care should be exercised when removing the spurs of the gland, which often go high on the neck, as the left tissue can cause a relapse of the disease. To remove the thymus, various «open» (transcervical, full, partial and oblique partial transsternal, right-, left- and bilateral transpleural), video-assisted (thoracoscopic, transcervical and subciphoidal, transoral) and robot-assisted surgical approaches are proposed. In this case, the choice of surgical access should be approached individually in each case.