Tubeless three-port versus conventional single utility port thoracoscopic surgery in the treatment of thymic tumors: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIU Yuchi , LIU Bo , MENG Hao , DING Renquan , LIU Xingchi , WANG Shiqi , HU Boxiao , WU Qiong , ZHANG Guoqing ,  XU Shiguang

1. Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China;

Corresponding author：

XU Shiguang, Email: oldmonitor73@163.com

Keywords：

Totally tubeless; thoracoscope; thymoma; enhanced recovery after surgery

DOI：

10.7507/1007-4848.202208027

Video：

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Objective To investigate the safety and efficacy of totally no tube three-port thoracoscopic surgery (TNTT) for thymic tumor via lateral thoracic approach. Methods The clinical data of patients with thymoma admitted to the Department of Thoracic Surgery of the General Hospital of Northern Theater Command from November 2021 to May 2022 were retrospectively analyzed. The patients were divided into a TNTT group and a single utility port video-assisted thoracic surgery (SVATS) group according to different surgical methods. The clinical data were compared between the two groups. Results A total of 111 patients were collected. There were 44 patients in the TNTT group, including 20 males and 24 females, with an average age of 60.11±8.64 years, and 67 patients in the SVATS group, including 30 males and 37 females, with an average age of 62.40±7.92 years. There was no significant difference between the two groups in the baseline data (P>0.05). The postoperative hospital stay and intraoperative blood loss were shorter or less in the TNTT group (P<0.05), and the visual analogue scale score 48 hours after the operation was smaller in the SVATS group (P<0.05). Conclusion TNTT has a good surgical safety, and can shorten postoperative hospital stay, reduce intraoperative blood loss, and has significant advantages in enhanced recovery after surgery, but SVATS can reduce postoperative pain in patients.

Citation： XIU Yuchi, LIU Bo, MENG Hao, DING Renquan, LIU Xingchi, WANG Shiqi, HU Boxiao, WU Qiong, ZHANG Guoqing, XU Shiguang. Tubeless three-port versus conventional single utility port thoracoscopic surgery in the treatment of thymic tumors: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(4): 546-550. doi: 10.7507/1007-4848.202208027 Copy

1.	曾锐, 杜铭. 达芬奇机器人与电视胸腔镜手术治疗纵隔肿瘤的临床对比研究. 中国医药指南, 2022, 20(11): 1-4.
2.	梁宝磊, 魏豪, 石珂, 等. 剑突下入路与侧胸入路胸腔镜手术治疗纵隔肿瘤近期疗效和安全性Meta分析. 中华胸部外科电子杂志, 2019, 6(2): 115-124.
3.	Yano M, Moriyama S, Haneda H, et al. The subxiphoid approach leads to less invasive thoracoscopic thymectomy than the lateral approach. World J Surg, 2017, 41(3): 763-770.
4.	Suda T. Subxiphoid uniportal video-assisted thoracoscopic surgery procedure. Thorac Surg Clin, 2017, 27(4): 381-386.
5.	Whitson BA, Andrade RS, Mitiek MO, et al. Thoracoscopic thymectomy: Technical pearls to a 21st century approach. J Thorac Dis, 2013, 5(2): 129-134.
6.	Mun M, Nakao M, Matsuura Y, et al. Video-assisted thoracoscopic surgery lobectomy for non-small cell lung cancer. Gen Thorac Cardiovasc Surg, 2018, 66(11): 626-631.
7.	Mu JW, Chen GY, Sun KL, et al. Application of video-assisted thoracic surgery in the standard operation for thoracic tumors. Cancer Biol Med, 2013, 10(1): 28-35.
8.	Singhal S, Shrager JB, Rosenthal DI, et al. Comparison of stages Ⅰ-Ⅱ thymoma treated by complete resection with or without adjuvant radiation. Ann Thorac Surg, 2003, 76(5): 1635-1641.
9.	Murakawa T, Nakajima J, Kohno T, et al. Results from surgical treatment for thymoma. 43 years of experience. Jpn J Thorac Cardiovasc Surg, 2000, 48(2): 89-95.
10.	Roth JV. Complications of one-lung ventilation: Is it the blood flow or the ventilation? Anesthesiology, 2016, 125(6): 1253-1254.
11.	Ishikawa Y, Tateyama H, Yoshida M, et al. Micronodular thymoma with lymphoid stroma: An immunohistochemical study of the distribution of Langerhans cells and mature dendritic cells in six patients. Histopathology, 2015, 66(2): 300-307.
12.	Guo K, Tong L, Li X, et al. Video-assisted thoracoscopic completion thymectomy based on mediastinal pleura guidance. J Thorac Dis, 2017, 9(5): 1382-1385.
13.	Zhang H, Zheng Y, Chen LQ, et al. Robotic resection of a thymoma behind the left innominate vein. Interact Cardiovasc Thorac Surg, 2019, 29(5): 813-815.
14.	Ruffini E, Filosso PL, Guerrera F, et al. Optimal surgical approach to thymic malignancies: New trends challenging old dogmas. Lung Cancer, 2018, 118: 161-170.
15.	Kang CH, Hwang Y, Lee HJ, et al. Robotic thymectomy in anterior mediastinal mass: Propensity score matching study with transsternal thymectomy. Ann Thorac Surg, 2016, 102(3): 895-901.
16.	Toker A. Standardized definitions and policies of minimally invasive thymoma resection. Ann Cardiothorac Surg, 2015, 4(6): 535-539.
17.	金大成, 韩松辰, 马继龙, 等. 机器人辅助与胸腔镜胸腺切除术的疗效对比: 系统评价与Meta分析. 临床荟萃, 2019, 34(2): 163-170.
18.	汪昉睿, 庞烈文, 傅剑华, 等. 合并重症肌无力的胸腺瘤患者术后生存的初步分析—ChART数据库回顾性结果. 中国肺癌杂志, 2016, 19(7): 418-424.
19.	张云峰, 于磊, 景筠, 等. 合并重症肌无力的胸腺瘤治疗与预后特点分析. 中华外科杂志, 2015, 53(8): 612-616.
20.	方文涛, 谷志涛, 陈克能. 胸腺肿瘤微创手术研究进展. 中国肺癌杂志, 2018, 21(4): 269-272.
21.	Jayaraman S, Davies W, Schlachta CM. Getting started with robotics in general surgery with cholecystectomy: The Canadian experience. Can J Surg, 2009, 52(5): 374-378.
22.	Ozdamar D, Turna C, Kibar A, et al. Tracheal injury: Late symptom after double-lumen tube intubation—A case report. J Pak Med Assoc, 2018, 68(11): 1711-1713.

1. 曾锐, 杜铭. 达芬奇机器人与电视胸腔镜手术治疗纵隔肿瘤的临床对比研究. 中国医药指南, 2022, 20(11): 1-4.
2. 梁宝磊, 魏豪, 石珂, 等. 剑突下入路与侧胸入路胸腔镜手术治疗纵隔肿瘤近期疗效和安全性Meta分析. 中华胸部外科电子杂志, 2019, 6(2): 115-124.
3. Yano M, Moriyama S, Haneda H, et al. The subxiphoid approach leads to less invasive thoracoscopic thymectomy than the lateral approach. World J Surg, 2017, 41(3): 763-770.
4. Suda T. Subxiphoid uniportal video-assisted thoracoscopic surgery procedure. Thorac Surg Clin, 2017, 27(4): 381-386.
5. Whitson BA, Andrade RS, Mitiek MO, et al. Thoracoscopic thymectomy: Technical pearls to a 21st century approach. J Thorac Dis, 2013, 5(2): 129-134.
6. Mun M, Nakao M, Matsuura Y, et al. Video-assisted thoracoscopic surgery lobectomy for non-small cell lung cancer. Gen Thorac Cardiovasc Surg, 2018, 66(11): 626-631.
7. Mu JW, Chen GY, Sun KL, et al. Application of video-assisted thoracic surgery in the standard operation for thoracic tumors. Cancer Biol Med, 2013, 10(1): 28-35.
8. Singhal S, Shrager JB, Rosenthal DI, et al. Comparison of stages Ⅰ-Ⅱ thymoma treated by complete resection with or without adjuvant radiation. Ann Thorac Surg, 2003, 76(5): 1635-1641.
9. Murakawa T, Nakajima J, Kohno T, et al. Results from surgical treatment for thymoma. 43 years of experience. Jpn J Thorac Cardiovasc Surg, 2000, 48(2): 89-95.
10. Roth JV. Complications of one-lung ventilation: Is it the blood flow or the ventilation? Anesthesiology, 2016, 125(6): 1253-1254.
11. Ishikawa Y, Tateyama H, Yoshida M, et al. Micronodular thymoma with lymphoid stroma: An immunohistochemical study of the distribution of Langerhans cells and mature dendritic cells in six patients. Histopathology, 2015, 66(2): 300-307.
12. Guo K, Tong L, Li X, et al. Video-assisted thoracoscopic completion thymectomy based on mediastinal pleura guidance. J Thorac Dis, 2017, 9(5): 1382-1385.
13. Zhang H, Zheng Y, Chen LQ, et al. Robotic resection of a thymoma behind the left innominate vein. Interact Cardiovasc Thorac Surg, 2019, 29(5): 813-815.
14. Ruffini E, Filosso PL, Guerrera F, et al. Optimal surgical approach to thymic malignancies: New trends challenging old dogmas. Lung Cancer, 2018, 118: 161-170.
15. Kang CH, Hwang Y, Lee HJ, et al. Robotic thymectomy in anterior mediastinal mass: Propensity score matching study with transsternal thymectomy. Ann Thorac Surg, 2016, 102(3): 895-901.
16. Toker A. Standardized definitions and policies of minimally invasive thymoma resection. Ann Cardiothorac Surg, 2015, 4(6): 535-539.
17. 金大成, 韩松辰, 马继龙, 等. 机器人辅助与胸腔镜胸腺切除术的疗效对比: 系统评价与Meta分析. 临床荟萃, 2019, 34(2): 163-170.
18. 汪昉睿, 庞烈文, 傅剑华, 等. 合并重症肌无力的胸腺瘤患者术后生存的初步分析—ChART数据库回顾性结果. 中国肺癌杂志, 2016, 19(7): 418-424.
19. 张云峰, 于磊, 景筠, 等. 合并重症肌无力的胸腺瘤治疗与预后特点分析. 中华外科杂志, 2015, 53(8): 612-616.
20. 方文涛, 谷志涛, 陈克能. 胸腺肿瘤微创手术研究进展. 中国肺癌杂志, 2018, 21(4): 269-272.
21. Jayaraman S, Davies W, Schlachta CM. Getting started with robotics in general surgery with cholecystectomy: The Canadian experience. Can J Surg, 2009, 52(5): 374-378.
22. Ozdamar D, Turna C, Kibar A, et al. Tracheal injury: Late symptom after double-lumen tube intubation—A case report. J Pak Med Assoc, 2018, 68(11): 1711-1713.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Tubeless three-port versus conventional single utility port thoracoscopic surgery in the treatment of thymic tumors: A retrospective cohort study

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