Subxiphoid uniportal approach using double sternum retractors versus subxiphoid and subcostal arch three-portal approach of video-assisted thoracoscopic surgery thymectomy for thymoma treatment: A retrospective cohort study
- VernacularTitle:胸腔镜剑突下单孔双拉钩与经剑突肋缘下三孔胸腺切除术治疗胸腺瘤的回顾性队列研究
- Author:
Jinlan ZHAO
1
;
Weiyang CHEN
2
;
Lin LIN
2
;
Lei WANG
2
;
Jie LI
2
;
Lin MA
2
;
Longqi CHEN
2
;
Hong CHEN
3
;
Dong TIAN
2
Author Information
1. West China School of Nursing, Sichuan University/Operating Room, Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
3. West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, P. R. China
- Publication Type:Journal Article
- Keywords:
Thymoma;
thymectomy;
thoracoscopic surgery;
subxiphoid uniportal;
double sternum retractors
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(04):482-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety of video-assisted thoracoscopic surgery (VATS) thymectomy for the treatment of thymoma through subxiphoid uniportal approach using double sternum retractors, and subxiphoid and subcostal arch approach. Methods We retrospectively analyzed the clinical data of the patients diagnosed with thymoma who underwent VATS thymectomy from June 2023 to June 2024 in West China Hospital. Patients were categorized based on the surgical approach into two groups: a subxiphoid uniportal VATS thymectomy (SUVT) group and a subxiphoid and subcostal arch VATS thymectomy (SASAT) group. Comparisons were made between the two groups regarding surgical duration, intraoperative blood loss, postoperative drainage, thymoma size and location, and postoperative pain assessed using the visual analogue scale (VAS). Results The SUVT group consisted of 20 patients, including 11 males and 9 females, with an average age of (51.5±14.3) years. The SASAT group comprised 40 patients, including 26 males and 14 females, with an average age of (50.0±13.0) years. Compared to the SASAT group, the SUVT group had significantly larger thymomas [ (5.9±2.7) cm vs. (4.2±2.1) cm, P=0.010] and a higher proportion of neoplasms located in the superior mediastinum (30.0% vs. 2.5%, P=0.007). Additionally, the VAS pain scores on postoperative days 3, 7, and 30 were significantly lower in the SUVT group compared to the SASAT group (P<0.05). There were no statistical differences between the two groups in demographic characteristics, operative time, intraoperative blood loss, duration and volume of postoperative drainage, length of postoperative hospital stay, or the VAS pain score on the first postoperative day. Conclusion SUVT using double sternum retractors significantly reduces postoperative pain and provides superior efficacy in the resection of larger thymomas or those situated in the superior mediastinum.
