First experience of thoracoscopic thymectomy from a uniportal subxiphoid approach

Abstract

Purpose of the study. Evaluation of the immediate results of using the subxiphoid approach in patients with non-invasive epithelial thymic tumors. Materials and methods. The experience of treatment of 14 patients who underwent thoracoscopic thymectomy using a single subxiphoid approach for non-invasive epithelial thymic tumors was analyzed. The age of the patients ranged from 24 to 70 years, the median was 42 years. There were 9 (64.3%) women, 5 (35.7%) men. All patients were diagnosed with stage I of the disease at the time of surgical treatment. The minimum size of the removed thymoma in the study was 15 mm, the maximum was 65 mm, and the median was 38 mm. Results. Two operations (14.3%) were associated with technical difficulties due to the presence of adhesions after previous pneumonia, which led to more pronounced intraoperative blood loss, which amounted to 200 ml. The duration of the operation varied from 60 to 180 minutes, the median being 82.5 minutes. In most cases (97.6%), the level of pain did not exceed 4 points on the visual analog pain scale (VAS). In the postoperative period, a surgical complication was observed - the formation of a retrosternal hematoma; there were no deaths. Conclusion. Performing thoracoscopic thymectomy from a single subxiphodal approach is a reasonable option for non-invasive Tet’s. This method allows you to perform the operation in full, without violating oncological principles. It has been proven that for tumors up to 65 mm in size, this technique does not lead to an increase in the duration of the operation and an increase in intraoperative complications.