AUTHOR=Li Bin , Niu Lijuan , Gu Chenqi , He Kaiwen , Wu Ruizhi , Pan Zhenfeng , Chen Shaomu 

TITLE=Clinical analysis of subxiphoid vs. lateral approaches for treating early anterior mediastinal thymoma

JOURNAL=Frontiers in Surgery

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.984043

DOI=10.3389/fsurg.2022.984043

ISSN=2296-875X

ABSTRACT=Objective: To investigate the clinical efficacy of subxiphoid approach for early anterior mediastinal thymoma and evaluate its advantages over lateral intercostal approach.
Methods: 345 patients with early anterior mediastinal thymoma from January 2016 to December 2020 in the First Affiliated Hospital of Soochow University were retrospectively analyzed.99 patients underwent subxiphoid video-assisted thoracoscopic thymectomy (S-VATT) and 246 patients underwent transthoracic video-assisted thoracoscopic thymectomy (T-VATT). We compared the intraoperative conditions of the two groups (including operation time, intraoperative blood loss), postoperative conditions (including postoperative pleural drainage volume, extubation time, postoperative hospital stay, postoperative visual analogue scale pain score VAS), postoperative complications (death, pneumonia, delayed wound healing, cardiac arrhythmia, phrenic nerve injury), and analyzed the clinical advantages of subxiphoid approach for early anterior mediastinal thymoma.
Results: There was no significant difference between the two groups in general clinical features, operation time, postoperative complications (P>0.05).There was significant difference in intraoperative blood loss, postoperative pleural drainage volume, tube extubation time, postoperative hospital stay, postoperative visual analogue scale pain score (VAS) and postoperative analgesics (significantly decreased flubiprofen axetil amount) (P<0.05).
Conclusion: Compared with lateral intercostal thoracic approach, subxiphoid approach had advantages in intraoperative blood loss, postoperative hospital stay, tube extubation time, postoperative pleural drainage volume, postoperative visual analogue scale pain score and analgesics dosage, and can provide a better view of the bilateral pleural cavities and more radical thymectomy and superior cosmesis, it has been proved to be a safe and feasible minimally invasive surgical method.