ArticleSurgery today2023
Perioperative outcomes of minimally invasive surgery for large malignant thymic epithelial tumors and for total thymectomy.
Article in Surgery today, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.
- Perioperative safety and efficacy of minimally invasive vs. open thymectomy for large thymomas: a systematic review and meta-analysis.Journal of robotic surgery · 2025Pooled it
- Robotic subxiphoid-optical thymectomy for Good's syndrome in a severely immunocompromised patient: a case report.Translational lung cancer research · 2026Article
- Nationwide trends in mediastinal tumor and myasthenia gravis surgery in Japan: a decade claims-based analysis (2014-2023).International journal of clinical oncology · 2026Article
- Surgical approach and tumor size influence outcomes in thymoma: a retrospective analysis of 70 cases.Surgical endoscopy · 2026Article
- Pathobiology of thymic epithelial tumours and the treatment strategy based on immuno-oncological characteristics: a narrative review.Mediastinum (Hong Kong, China) · 2026Review
- Narrative review of the prognostic significance of primary tumor size in thymic epithelial tumor.Mediastinum (Hong Kong, China) · 2025Review
Corrections and comments
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Authors and funding
9 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMinimally invasive surgery (MIS) for thymic tumors is now accepted widely, in line with improved surgical techniques; however, we occasionally encounter complicated cases of large tumors or of total thymectomy requiring prolonged operative duration or conversion to an open procedure (OP). We reviewed patients registered in a nationwide database to identify the technical feasibility of MIS for thymic epithelial tumors.
methodsData on patients treated surgically between 2017 and 2019 were extracted from the National Clinical Database of Japan. Clinical factors and operative outcomes were calculated by tumor diameter using trend analyses. Perioperative outcomes of MIS for non-invasive thymoma were investigated using propensity score-matched analyses.
resultsMIS was performed in 46.2% of the patients. The operative duration and conversion rate increased with the tumor diameter (p < .001). After propensity score-matching, operative duration and postoperative hospital stay were shorter (p < .001), and the transfusion rate was lower (p = .007) in patients who underwent MIS than in those who underwent OP for thymomas ≥ 5 cm. Among patients who underwent total thymectomy, blood loss was less (p < .001) and the postoperative hospital stay was shorter (p < .001) in those who underwent MIS than in those who underwent OP. There were no significant differences in postoperative complications and mortality.
conclusionsMIS is technically feasible even for large non-invasive thymomas or for total thymectomy, although the operative duration and open conversion rate increase with the tumor diameter.
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