Thoracoscopic versus Open Approach in Thymectomy: Center Experience Study

Background: Minimally invasive thymectomy using VATS has emerged as an effective option in the management of thymic disorders, particularly in cases of benign thymic epithelial tumors.
Aim of the Study: This study aimed to evaluate and contrast two surgical approaches for thymectomy, video-assisted thoracoscopic surgery (VATS) and open sternotomy while analyzing their associated outcomes and complication rates.
Patients and Methods: A prospective randomized cross-sectional analysis was performed at Menoufia University Hospitals involving 30 patients scheduled for thymectomy. Participants were randomly assigned into two equal groups: Group A (15 patients) underwent VATS thymectomy, while Group B (15 patients) received open thymectomy through sternotomy.
Results: There were statistically significant differences between open thymectomy group and VATS thymectomy group as regard anesthesia, surgical approach, epidural analgesia, ICU stay and intra-operative blood loss, narcotic requirement, pain score, wound and chest infection, postoperative bleeding and hospital stay (p<0.05). There was no statistically significant difference as regard analgesia required 14 days postoperative and conversion to open and incomplete excision
(p>0.05). Complications in open Thymectomy Group showed that 10 (66.7%) had wound infection and 5(33.3%) had chest infection while in VATS Thymectomy Group 5(33.3%) had Phrenic nerve injury.
Conclusions: Compared to the open approach, VATS thymectomy demonstrated greater safety in thymoma cases, with advantages including shorter hospitalization, decreased intra-operative blood loss, lower risk of postoperative infection, and faster recovery.