A Retrospective Study Of Subxiphoid Approach And Lateral Thoracic Approach In The Treatment Of Anterior Mediastinal Tumors

Objective: The perioperative data of patients with anterior mediastinal tumors treated by thoracoscopic surgery via lateral thoracic approach("lateral thoracic approach")and subxiphoid approach("subxiphoid process")were analyzed retrospectively.furthermore,to explore the feasibility and clinical value of thoracoscopic anterior mediastinal tumor surgery by subxiphoid process approach.Methods: Among the patients who underwent anterior mediastinal tumor resection in the Department of General Thoracic surgery of the 940 th Hospital of the Joint Logistics support Force of the Chinese people’s Liberation Army from January 2016 to December 2019,40 patients underwent thoracoscopic anterior mediastinal tumor resection via lateral thoracic approach.40 patients underwent thoracoscopic anterior mediastinal tumor resection by subxiphoid approach,and the perioperative data of the two groups were compared.Including operation time,intraoperative blood loss,total postoperative drainage,postoperative extubation time,postoperative visual pain score,postoperative hospital stay,hospitalization costs,postoperative complications and inflammation indexes,etc.to evaluate the advantages and disadvantages of the two surgical methods for the treatment of mediastinal tumors before treatment.Results: There was no perioperative death in the two groups,and all patients were discharged smoothly.For patients with anterior mediastinal tumor complicated with myasthenia gravis,complete resection of anterior mediastinal tumor and its surrounding tissue was ensured.By comparing the perioperative data of the two groups,there was no significant difference in preoperative general data,such as sex,age,BMI,complications,smoking history,etc(P>0.05),and there was no significant difference in intraoperative data,such as operation time and intraoperative blood loss between the two groups(P>0.05).There was no significant difference in postoperative data,such as postoperative hospital stay,maximum diameter of postoperative specimen,postoperative inflammatory index and hospitalization cost(P>0.05).However,there were significant differences in total postoperative drainage,postoperative extubation time,postoperative visual pain score,postoperative first landing time and days of use of analgesics(P<0.05).Conclusion: Video-assisted thoracoscopic surgery via subxiphoid approach is a safe and feasible method for the treatment of anterior mediastinal tumors.Compared with lateral thoracic approach,thoracoscopic surgery has less postoperative pain and more beautiful incision.Under the condition of mature medical equipment and technology,it should be actively promoted.