Department of Thoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225000, China.
Department of Thoracic Surgery, The Yangzhou School of Clinical Medicine of Dalian Medical University, Yangzhou, 225000, China.
J Cardiothorac Surg. 2024 Oct 7;19(1):595. doi: 10.1186/s13019-024-03081-3.
Surgical approach in the treatment of thymoma is varied. This retrospective study aimed to evaluate the outcomes of different surgical approaches in the treatment of thymoma.
From January 2020 to December 2023, a total of 208 patients underwent thoracoscopic surgical treatment and were diagnosed with thymoma by postoperative pathological result in our institution. We collected and then analysed potential factors including general conditions, surgical approaches, preoperative clinical symptoms, surgical procedures, postoperative hospital stay, postoperative drainge, postoperative pain score, postoperative complications and postoperative follow-up.
Of the 208 patients, 98 patients underwent surgery via subxiphoid approach (47.1%) and 110 patients via lateral intercostal approach (52.8%). The duration of the surgical procedure (P = 0.02), intraoperative blood loss (P = 0.045), total postoperative drainage (P = 0.021), postoperative drainage per day (P = 0.004) and Postoperative pain score (Day1 P = 0.010 and Day2 P = 0.002)showed a significant difference between these two groups. 31 patients (14.9%) received postoperative radiotherapy. One patient died due to postoperative radiotherapy. No recurrence occurred in one-year follow-up.
The present study not only showed that subxiphoid approach was a safe and feasible technique for thymoma, with a potentially faster postoperative recovery and less postoperative pain.
胸腺肿瘤的手术治疗方法多种多样。本回顾性研究旨在评估不同手术入路治疗胸腺瘤的效果。
2020 年 1 月至 2023 年 12 月,我院共对 208 例经术后病理证实为胸腺瘤的患者进行了电视胸腔镜手术治疗。我们收集并分析了包括一般情况、手术入路、术前临床症状、手术方式、术后住院时间、术后引流量、术后疼痛评分、术后并发症及术后随访等潜在因素。
208 例患者中,98 例行剑突下入路(47.1%),110 例行侧胸入路(52.8%)。手术时间(P=0.02)、术中出血量(P=0.045)、总术后引流量(P=0.021)、术后每日引流量(P=0.004)及术后疼痛评分(术后第 1 天 P=0.010,术后第 2 天 P=0.002)差异均有统计学意义。31 例(14.9%)患者术后接受了放疗。1 例患者死于术后放疗。术后 1 年随访无复发。
本研究表明,剑突下入路治疗胸腺瘤是一种安全可行的技术,术后恢复更快,疼痛更轻。