Long-term outcome in mediastinal malignancies: video-assisted thoracoscopic versus open surgery
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ORIGINAL ARTICLE
Long-term outcome in mediastinal malignancies: video-assisted thoracoscopic versus open surgery Huynh Quang Khanh 1 & Nguyen Van Khoi 1,2 & Nguyen Lam Vuong 2,3 Received: 5 June 2020 / Revised: 20 July 2020 / Accepted: 24 July 2020 # Indian Association of Cardiovascular-Thoracic Surgeons 2020
Abstract Purpose There are not many studies comparing long-term oncological outcomes between video-assisted thoracoscopic surgery (VATS) and open surgery for mediastinal malignancies. This study aimed to compare perioperative and long-term outcomes of these two techniques in the treatment of mediastinal malignancies. Methods This is a retrospective study: patients with mediastinal malignancies underwent VATS or open surgery from 2010 to 2013 and were followed until 2019. The primary endpoints were long-term oncological outcomes, including tumor recurrence and mortality. Secondary endpoints were perioperative outcomes (operative duration, blood loss, pain, chest drainage duration, hospital length of stay, and complications). Results There were 36 patients in the VATS group and 49 patients in the open group. The median follow-up duration was 90 months. VATS significantly reduced operation time (84.6 versus 124.8 min), blood loss (59.8 versus 235.2 ml), postoperative pain score (4.9 versus 6.7), the duration of chest tube drainage (2.1 versus 3.1 days), and postoperative hospital stay (5.2 versus 8.0 days). The two groups were comparable regarding the recurrence rate (2.4 versus 2.1/100 person-years) and mortality rate (0.8 versus 0.9/100 person-years). Conclusion Compared with open surgery, VATS is less traumatic, reduces postoperative chest drainage, and shortens hospital stay with comparable long-term oncological outcomes. We advocate the VATS approach as a favored option for the resection of mediastinal malignancies. Keywords Video-assisted thoracoscopic surgery . Thoracotomy . Sternotomy . Mediastinal tumor . Malignancy
Introduction Mediastinal tumors include benign and malignant growths that form in either anterior, middle, or posterior mediastinum. Approximately one-third of all mediastinal tumors are malignant [1]. They are quite rare, which consist less than 1% of all types of cancer [2]. Mediastinal malignancies comprise a diverse group of tumors, including thymic cancers, lymphoma, * Nguyen Lam Vuong [email protected] 1
Department of Thoracic Surgery, Cho Ray Hospital, Ho Chi Minh City, Vietnam
2
Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
3
Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam
teratoma, and several uncommon types of tumor. These tumors are usually diagnosed in patients aged 30 to 50 years and the thymoma is the most common type of mediastinal tumors reported in adults [1, 3, 4]. Surgery has been the primary treatment mod
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