For early-stage thymic epithelial tumors (TETs) , advocation for partial thymectomy or even thymomectomy has always existed. The concept of hemi-thymectomy is based on the anatomical structure of the thymus; and it is devised to be applied to early-stage TETs and benign thymic lesions located entirely on one lobe of the thymus. This article summarized our preliminary experience with this novel surgical extent including both peri-operative outcomes and short-term prognosis.

Over a 12-month period, a total of 31 patients underwent minimally invasive hemi-thymectomy. The clinical characteristics, co-morbidities, peri-operative results, final pathology and short-term prognosis of these patients were summarized.

A total of 11 males and 20 females with a mean age of 52.7 (35–77) years underwent minimally invasive hemi-thymectomy for their anterior mediastinal lesions. Twenty-six of them had various degrees of co-morbidities: 12 with overweight, 9 with hypertension, 3 with diabetes mellitus, 1 with leukopenia and 1 with endometrial stromal sarcoma. All 31 hemi-thymectomies via the anterolateral minimally invasive approach were successful without intra-operative adverse events. The mean operation time was 60.83 (31–91) min. The mean intra-operative blood loss was 49.5 (20–200) mL. There were no deaths in peri-operative period. The mean post-operative hospital stay was 1.3 (1–2) days; the mean drainage volume on the first post-operative day was 77.8 (0–350) mL. The mean chest drainage tube indwelling time was 0.7 (0–2) days. Drainage tubes of 10 patients were removed within 24 hours after the surgery. The pathology results showed 21 thymomas, 7 teratomas and 3 hemangiomas. All 21 thymomas were UICC pT1aN0M0. No recurrence was observed during the follow-up (6–12 months) .

Hemithymectomy, a new range of thymectomy based on thymic anatomy, is used to treat early-stage, non-myasthenia gravis-derived tumors of thymic epithelial origin and benign lesions located in one thymus. Preliminary exploration suggests that this is a safe and effective resection method with good perioperative and short-term oncological outcomes. In theory, hemithymectomy has inherent advantages over traditional total thymectomy, and can provide a faster and safer surgical experience for a selected group of patients.