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Subxiphoid Uniportal VATS for Thymic and Combined Mediastinal and Pulmonary Resections – A Two-Year Experience
- Source :
- Seminars in Thoracic and Cardiovascular Surgery. 31:614-619
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Compared to the intercostal approach, subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) is considered to be less invasive as it may cause minimal postoperative pain. Besides, it provides an excellent view of the bilateral pleural cavities. In this paper, we describe our technique and overview a 2-year experience results in this approach for the surgical treatment of anterior mediastinal and pulmonary lesions. In a retrospective study of data collected prospectively between October 2014 and December 2016, 38 patients underwent surgery for an anterior mediastinal tumor or myasthenia gravis at our institution. Intraoperative factors like duration of operation and amount of blood loss were analyzed as well as postoperative ones, including duration of chest drains, amount of postoperative fluid drainage, and length of hospital stay. The median age of patients was 59 years (36-80 years) with 19 females (50%). Overall, 28 patients (74%) underwent extended thymectomy. Seven patients (19%) experienced a combined lung resection and extended thymectomy, 3 (7%) a resection of pericardial (2) or bronchogenic (1) cysts. The median diameter of the lesions was 2.93 cm (1.2-7.7 cm). Postoperatively, 30-day mortality was 0%. Subxiphoid uniportal VATS is a convenient approach for minimally invasive mediastinal surgery. The excellent exposure of the anterior mediastinum and the possibility of conducting complex procedures, such as extended thymectomies and combined mediastinal and pulmonary resections with good results of minimal morbidity, represent the strong points of this technique. Thoracic surgeons experienced in VATS can safely perform subxiphoid uniportal VATS for mediastinal surgery.
- Subjects :
- Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Time Factors
Databases, Factual
medicine.medical_treatment
Operative Time
Blood Loss, Surgical
Extended thymectomy
Mediastinal tumor
030204 cardiovascular system & hematology
Anterior mediastinum
Resection
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Blood loss
Risk Factors
Myasthenia Gravis
medicine
Humans
Pneumonectomy
Aged
Retrospective Studies
Aged, 80 and over
Thoracic Surgery, Video-Assisted
business.industry
Retrospective cohort study
General Medicine
Middle Aged
Thoracic Neoplasms
Thymectomy
medicine.disease
Surgery
Treatment Outcome
030228 respiratory system
Video-assisted thoracoscopic surgery
Female
Lung resection
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 10430679
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Seminars in Thoracic and Cardiovascular Surgery
- Accession number :
- edsair.doi.dedup.....acbbf6fdc10583d93a5f402648271a08