| Objectives:To investigate the value of VATS in the treatment of thymoma by comparing the outcome of VATS and conventional surgery.Methods:The clinical data of 104 patients underwent surgery were collected from Jul.2005 to Jul.2009 at the thoracic surgery department of the second affiliated hospital of dalian medical university.Size of all thymoma was less than 6cm.52 cases of them treated by VATS were did as the study group,and the other 52 cases treated by conventional surgery including 5 cases changed by VATS after thoracoscopic exploration were did as the control group.The value of VATS thymoma resection is studied by comparing two groups by the following aspects:incision size,operative time,blood loss during operation,the time of postoperative drainage tube left in chest,pleural or mediastinal drainage,the amount of pain medicine, postoperative hospitalization days,complications,recurrence and death of tumor.Results:52 cases were totally completed by VATS thymoma resection,52 cases were performed by conventional surgery including 5 patients changed to do open surgery after thoracoscopic exploration.All the diagnosis have been confirmed by pathology after operation.In study group: incision size (5.16±0.59) cm,operative time (124.80±25.33) min,blood loss during operation (74.40±22.03) ml,the time of postoperative drainage tube left in chest (2.08±0.82) d, pleural or mediastinal drainage(204.00±56.83)ml, the amount of pain medicine (45.00±28.06) mg,postoperative hospitalization days (4.60±0.42) d;In control group:incision size (13.50± 2.50) cm,operative time (124.80±25.33) min,blood loss during operation (124.00±22.28) ml,the time of postoperative drainage tube left in chest (4.06±0.73) d, Pleural or mediastinal drainage (370.00±83.67) ml,the amount of pain medicine (93.00±34.20) mg,postoperative hospitalization days (7.00±1.58) d.The comparisons of data of two groups show that the statistical differences were significant (P<0.05).The comparisons of postoperative complications also show that the study group is better than the control group.There were only two cases in the study group which account for 3.85%(2/52) and eight cases in the control group which account for 15.38%(8/52) and the difference was statistically significant (P <0.05).The comparison of follow-up of chronic pain,upper limb movement disorder also shows that the study group is better than the control group. There is no person suffered by chronic pain or upper limb movement disorder in the study group,but in the control group there are 9 cases with chronic chest pain and 5 cases with upper limb movement disorder, accounting for 17.30%.The difference was statistically significant (P<0.05). The two groups were followed up for 5 months-4 years,there is only 1 cases with re-issuing second surgery and no death in the study group,accounting for 1.92%;and there are one case recurrence and one case death in the control group,accounting for 3.85%.there are no statistically significant (P>0.05).Conclusions:VATS thymoma resection can be completely carried out. VATS thymoma resection has following advantages:small incision,small scar,less surgical trauma,less blood loss,short surgical time,short time of postoperative pleural or mediastinal drainage,less drainage amount,mild postoperative pain,quick recovery,less complications,low incidence of chronic pain and upper limb movement disorder after surgery,short hospital stay time and improving significantly postoperative quality of life.This kind of operation is feasible and safe.Therefore VATS thymoma resection has clinical significance and this method is worth to promote.
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