tailieunhanh - Báo cáo y học: "En bloc Extended Total Thymectomy and Extrapleural Pneumonectomy in Masaoka stage IVA Thymomas"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: En bloc Extended Total Thymectomy and Extrapleural Pneumonectomy in Masaoka stage IVA Thymomas. | Yang et al. Journal of Cardiothoracic Surgery 2011 6 28 http content 6 1 28 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access En bloc Extended Total Thymectomy and Extrapleural Pneumonectomy in Masaoka stage IVA Thymomas 1 1 -1 1 1 Hee Chul Yang Yoo Sang Yoon Hong Kwan Kim Yong Soo Choi Kwhanmien Kim Young Mog Shim Jungho Han3 Jhingook Kim1 Abstract Background Surgical excision is the primary treatment for a thymoma. However for advanced thymoma that extends to within the thoracic cavity and for recurrent cases with pleural dissemination Masaoka stage IVA the appropriate treatment is controversial. We evaluated the safety of surgery and outcomes of seven patients that underwent an en bloc extended total thymectomy and extrapleural pneumonectomy for stage IVA thymomas. Methods From 1994 to 2009 five patients initially diagnosed with pleural dissemination and two patients with recurrent tumors in the pleura and lungs after a total thymectomy were identified. Seven patients had an extrapleural pneumonectomy performed. For the first operation five patients underwent additional en bloc extended total thymectomy. Results Two recurrent cases were identified and months after first operation. Two patients had WHO type B1-B2 tumors two had B2 two had B2-B3 and one had a B3 tumor. The mean hospital stay was days range 7-29 . There was no operative mortality. Four patients had neoadjuvant chemotherapy and five were treated with adjuvant chemotherapy. The median survival was months and the Kaplan-Meier 2-year survival was 100 95 confidence interval months . One patient who did not receive induction chemotherapy had distant metastases after surgery. Conclusions En bloc extended total thymectomy and extrapleural pneumonectomy can be safely performed on selected patients with stage IVA thymomas and is expected to achieve complete local control. Although the treatment strategy has yet to be .