Perioperative effects of video-assisted thoracoscopic extended thymectomy via intercostal and subxiphoid approaches

doi:10.3760/cma.j.issn.1007-1245.2023.21.017

Abstract

Abstract:

Objective　To compare the clinical efficacy and safety of intercostal video-assisted thoracic surgery (VATS) and subxiphoid video-assisted thymectomy surgery (SVATS) in the treatment of thymomas. Methods　A retrospective analysis was conducted on 100 patients with thymomas in the Department of Thoracic and Cardiovascular Surgery, Huaihe Hospital of Henan University from November 2018 to November 2022. All patients underwent total thymectomy and mediastinal fat removal, who were divided into a SVATS group and a VATS group according to the surgery approaches. There were 20 males and 21 females aged (62.22±5.85) years in the VATS group. There were 29 males and 33 females aged (60.06±8.06) years in the SVATS group. The clinical data and perioperative indicators [operation time, intraoperative blood loss, postoperative Visual Analogue Scale (VAS) score, and postoperative hospital stay] of the two groups were compared. t test and χ² test were used. Results　There were no statistically significant differences in the clinical data and operation time between the two groups (all P>0.05). The intraoperative blood loss [(53.68±4.39) ml] in the SVATS group was less than that in the VATS group [(87.71±28.50) ml], the postoperative hospital stay [(2.63±0.65) d] was shorter than that in the VATS group [(3.71±0.67) d], and the VAS score 48 h after operation [(3.63±1.49) points] was lower than that in the VATS group [(4.98±1.65) points], with statistically significant differences (t=9.260, 8.154, and 4.312; all P<0.05). Conclusion　SVATS has advantages over VATS in safety, less intraoperative bleeding, less postoperative pain, and significantly shortened postoperative hospital stay for treating thymomas.

Key words:

Thoracoscope, Thymomas, Extended thymectomy, ERAS

摘要：

目的　对比经肋间电视胸腔镜外科手术（经肋间入路）与经剑突下电视胸腔镜胸腺切除手术（经剑突下入路）治疗胸腺瘤的临床疗效与安全性。方法　回顾性分析2018年11月至2022年11月河南大学淮河医院胸心血管外科收治的103例胸腺瘤患者为研究对象，根据手术入路不同分为经肋间入路组（41例）和经剑突下入路组（62例），所有患者均行胸腺全切术及纵隔脂肪清除。经肋间入路组男20例、女21例，年龄（62.22±5.85）岁；经剑突下入路组男29例、女33例，年龄（60.06±8.06）岁。对比两组患者临床资料及围手术期相关指标［手术时间、术中出血量、术后疼痛视觉模拟量表（VAS）评分及术后住院时间］。采用t检验、χ²检验。结果　两组患者临床指标及手术时间比较，差异均无统计学意义（均P>0.05）。经剑突下入路组术中出血量［（53.68±4.39）ml］少于经肋间入路组［（87.71±28.50）ml］，术后住院时间［（2.63±0.65）d］短于经肋间入路组［（3.71±0.67）d］，术后48 h VAS评分［（3.63±1.49）分］低于经肋间入路组［（4.98±1.65）分］，差异均有统计学意义（t=9.260、8.154、4.312，均P<0.05）。结论　经剑突下入路较经肋间入路术中出血量显著减少，术后疼痛减轻，术后住院时间明显缩短，有良好的手术安全性。

关键词:

胸腔镜, 胸腺瘤, 胸腺扩大切除, 加速康复外科

Li Xiapeng, Zhang Haifeng, Zhang Feng, Hu Baoli, Wei Haitao.

Perioperative effects of video-assisted thoracoscopic extended thymectomy via intercostal and subxiphoid approaches [J]. International Medicine and Health Guidance News, 2023, 29(21): 3066-3069.

李霞鹏张海峰张锋胡宝利韦海涛.

经肋间与经剑突下电视胸腔镜胸腺切除围手术期效果的研究 [J]. 国际医药卫生导报, 2023, 29(21): 3066-3069.

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