The Subxiphoid Approach Leads to Less Invasive Thoracoscopic Thymectomy Than the Lateral Approach

Abstract

The subxiphoid approach leads to a less invasive operation for anterior mediastinal tumors and extends the indications for VATS for invasive anterior mediastinal tumors.

Thoracoscopic Thymectomy Using a Subxiphoid Approach for Anterior Mediastinal Tumors

“…[5][6][7][8][9]15) However, while the lateral approach is useful for PT of tumors that are obviously deviated to the right or left thoracic cavity, performing total thymectomy using the lateral approach can be difficult, even with thoracic ports placed on both sides of the thoracic wall, and a cervical incision is occasionally required. 11,15) As three ports are set on each side with the lateral approach, six or seven incisions may be necessary to perform total thymectomy using this approach. 11,15) Reducing the number of thoracic ports led to a reduction in pain due to damage of the intercostal nerves.…”

“…11,15) As three ports are set on each side with the lateral approach, six or seven incisions may be necessary to perform total thymectomy using this approach. 11,15) Reducing the number of thoracic ports led to a reduction in pain due to damage of the intercostal nerves. Therefore, we recently changed our main approach for thymectomy to the subxiphoid approach.…”

“…Therefore, we recently changed our main approach for thymectomy to the subxiphoid approach. 10,11) In addition to achieving pain relief, the performance of thymectomy is easier using the subxiphoid approach than the lateral approach. In the lateral approach, the view is limited to the lateral direction.…”

“…10,11) For the procedure, the patient was placed in a lithotomy or supine position with their legs spread. A small transverse skin incision was typically made 1-2 cm below the lower edge of the xiphoid.…”

“…[5][6][7][8][9] We recently elected to perform thymectomy via the subxiphoid approach. 10,11) In the present retrospective study, 36 cases of mediastinal tumors deemed able to be treated with thymectomy using only the subxiphoid approach were reviewed to determine the safety and usefulness of the subxiphoid approach.…”