Clinical features and outcomes of video-assisted thoracoscopic thymectomies for thymic lymphomas

Background. With small sizes of thymus tumors, modern treatment protocols make it possible to resection them without prior histological verification on the basis of a computed tomography agreement. However, the differential diagnosis of thymomas and thymic lymphomas is extremely difficult. Today there is no clarity about the short-term results and long-term effects of operations in patients with lymphomas in the registry of minimally invasive techniques and video-assisted thoracoscopic thymectomy (VATS TE) in particular. Objective. To improve the results of diagnosis and treatment of thymus tumors by analyzing the diseases of patients with thymic lymphomas and follow-on development of treatment and diagnostic tactics. Material and methods. A retrospective analysis of the data of 26 patients with thymus lymphomas (main group), who underwent VATS TE in our center from 2001 to 2020, was carried out. The control group included 53 patients with thymomas who were similarly involved in surgical interference over the same period of time. The medical data, immediate and long-term results were analyzed. Results. Thymic lymphomas accounted for 8.3% of all solid tumors of the thymus and were associated with myasthenia in 3.8%. These patients had a younger age compared to thymomas — 32.8 and 53.2 (p<0.001), respectively. VATS TE for lymphomas were characterized by a several larger extent of intraoperative blood loss compared to thymomas — 50 ml against 30 ml (p=0.002), but a shorter period of hospitalization — 4.1 and 7.8 days (p<0.001). The median follow-up was 113.5 months. During the entire period of observation, no long-term complications and after-effectiveness of the operation were detected. The adjusted survival rate for patients with thymic lymphomas was 91.1%. Conclusions. VATS TE for thymic lymphomas is characterized by a low frequency of postoperative complications and does not adversely affect long-term results, and therefore can be recommended as a therapeutic and diagnostic operation for small encapsulated tumors without prior histological verification of the diagnosis.