Video-assisted thoracoscopic surgery with Subxyphoid approach in treatment of anterior mediastinal tumor

doi:10.3877/cma.j.issn.2095-8773.2018.01.04

Abstract

Abstract:

Objective

To discuss the security, effectiveness and risk factors of video-assisted thoracoscopic surgery with subxyphoid approach in treatment of anterior mediastinal tumor.

Methods

The clinical data of 87 patients with anterior mediastinal cancer who were hospitalized in Department of Thoracic Surgery, Union Clinical Medical College of Fujian Medical University from June 2014 to June 2016 were collected and divided into I-VATS group (n = 40) and S-VATS (n= 47). The differences of operation time, intraoperative blood loss, postoperative catheterization time, drainage volume, analgesic use time, hospitalization cost and postoperative hospital stay were compared.

Results

The two groups’ surgeries were successful, no transfer of thoracotomy cases, no deaths during follow-up. The time of catheterization, drainage of thoracic cavity and the time of using analgesic drugs in S-VATS group were significantly less than those in I-VATS group [(2.4 ± 0.1) d vs (2.9 ± 0.2) d, P< 0.05]; (203.1 ± 29.9) ml vs (462.9 ± 54.1) ml, P <0.01; (0.9 ± 0.2) d vs (2.5 ±0.3) d, P<0.01] And postoperative hospitalization costs were slightly higher than the I-VATS group, but the difference was not statistically significant (P>0.05). All cases were followed up for 10-24 months. There was no local recurrence in S-VATS group.

Conclusions

The video-assisted thoracoscopic surgery with subxyphoid approach for the treatment of anterior mediastinal tumor is safe and feasible.It is reliable minimally invasive, light pain and safety.It is an important and advanced treatment.

Key words: Subxyphoid approach, Intercostal approach, Video-assisted thoracoscopic surgery, Anterior mediastinal tumor

Kaiming Peng, Mingqiang Kang, Jihong Lin, Shaobin Yu. Video-assisted thoracoscopic surgery with Subxyphoid approach in treatment of anterior mediastinal tumor[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2018, 05(01): 16-21.

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Figures/Tables 3

References 13

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项目		S-VATS组(n＝47)	I-VATS组(n＝40)	统计值	P值
性别[n(%)]		?	?	χ²＝0.028	0.866
?	男性	22(46.8)	18(45.0)	?	?
?	女性	25(53.2)	22(55.0)	?	?
年龄(±s，岁)		49.2±15.9	51.6±12.9	t＝0.775	0.44
肿瘤直径(±s，cm)		3.0±1.6	3.4±1.6	t＝1.249	0.215
肿瘤类型[n(%)]		?	?	χ²＝6.897	0.141
?	胸腺瘤	10(21.3)	13(32.5)	?	?
?	囊肿	27(57.4)	15(37.5)	?	?
?	畸胎瘤	1(2.1)	1(2.5)	?	?
?	胸腺增生	7(14.9)	4(10)	?	?
?	其他	2(4.3)	7(17.5)	?	?

项目		S-VATS组(n＝47)	I-VATS组(n＝40)	统计值	P值
性别[n(%)]		?	?	χ²＝0.028	0.866
?	男性	22(46.8)	18(45.0)	?	?
?	女性	25(53.2)	22(55.0)	?	?
年龄(±s，岁)		49.2±15.9	51.6±12.9	t＝0.775	0.44
肿瘤直径(±s，cm)		3.0±1.6	3.4±1.6	t＝1.249	0.215
肿瘤类型[n(%)]		?	?	χ²＝6.897	0.141
?	胸腺瘤	10(21.3)	13(32.5)	?	?
?	囊肿	27(57.4)	15(37.5)	?	?
?	畸胎瘤	1(2.1)	1(2.5)	?	?
?	胸腺增生	7(14.9)	4(10)	?	?
?	其他	2(4.3)	7(17.5)	?	?

组别	术中指标		术后指标
组别	手术时间(min)	术中出血量（ml）	置管时间（d）	胸腔引流量（ml）	镇痛药使用时间（d）	住院费用(元）	术后住院时间（d）
I-VATS组（n = 40)	104. 4±6. 9	46. 4±6. 4	2. 9±0. 2	462. 9±58. 1	2. 5±0. 3	22937±958	4. 2±0. 3
S-VATS组（n = 47)	117. 1±6. 0	46. 9±12. 8	2. 4±0. 1	203. 1±30. 7	0. 9 ±0. 2	23930±971	3. 8±0. 3
t值	-1. 399	-0. 036	2. 062	4. 121	4. 830	-0. 722	1. 136
P值	0. 165	0. 971	0. 042	<0. 01	<0. 01	0. 472	0. 259

组别	术中指标		术后指标
组别	手术时间(min)	术中出血量（ml）	置管时间（d）	胸腔引流量（ml）	镇痛药使用时间（d）	住院费用(元）	术后住院时间（d）
I-VATS组（n = 40)	104. 4±6. 9	46. 4±6. 4	2. 9±0. 2	462. 9±58. 1	2. 5±0. 3	22937±958	4. 2±0. 3
S-VATS组（n = 47)	117. 1±6. 0	46. 9±12. 8	2. 4±0. 1	203. 1±30. 7	0. 9 ±0. 2	23930±971	3. 8±0. 3
t值	-1. 399	-0. 036	2. 062	4. 121	4. 830	-0. 722	1. 136
P值	0. 165	0. 971	0. 042	<0. 01	<0. 01	0. 472	0. 259

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