Mini-clamshell sternotomy for resection of recurrent thymic carcinoid tumors after extended thymothymectomy: report of a case and surgical procedure

Efficacy of robot‐assisted thoracoscopic surgery for managing thymoma recurrence following sternotomy: a case report

“…In the current case, we opted for the left‐sided RATS approach for recurrent thymoma based on the findings of the previous surgery despite the possibility of severe adhesions following median sternotomy. Marulli et al reported that single pleuropulmonary or mediastinal unilateral noninvasive recurrence represents the best indications for thoracoscopic resection 2 . We considered conversion to median sternotomy or a mini‐clamshell incision 3 if severe adhesions or cicatrization in the mediastinum was noted.…”

“…Marulli et al reported that single pleuropulmonary or mediastinal unilateral noninvasive recurrence represents the best indications for thoracoscopic resection. 2 We considered conversion to median sternotomy or a mini‐clamshell incision 3 if severe adhesions or cicatrization in the mediastinum was noted. In this case, the tumor could be dissected from the left brachiocephalic vein; however, the option for conversion of the procedure is vital as there is a risk of intraoperative vascular injury owing to the possibility of severe adhesions in revision surgery.…”

“…We prepared to use temporary endoscopic vascular clips for vascular suturing. If the dissection of the tumor and left brachiocephalic vein was challenging, we considered conversion to median sternotomy or a mini‐clamshell incision 2 . Additionally, due to potential difficulties with thoracotomy depending on the state of adhesions, we requested that the cardiovascular surgeon also prepare the patient for percutaneous cardiopulmonary support.…”