文献类型：期刊文献

英文题名：Clinical efficacy of robot-assisted subxiphoid versus lateral thoracic approach in the treatment of anterior mediastinal tumors

作者：Hong, Ziqiang[1,2];Sheng, Yannan[1];Bai, Xiangdou[1,2];Cui, Baiqiang[1,2];Lu, Yingjie[1];Wu, Xusheng[1,2];Cheng, Tao[1,2];Jin, Dacheng[2];Gou, Yunjiu[2]

第一作者：Hong, Ziqiang

通信作者：Gou, YJ[1]

机构：[1]Gansu Univ Chinese Med, Gansu Prov Hosp, Clin Med Coll 1, Lanzhou, Peoples R China;[2]Gansu Prov Hosp, Dept Thorac Surg, Lanzhou, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Prov Hosp, Dept Thorac Surg, Lanzhou, Peoples R China.

年份：2023

卷号：21

期号：1

外文期刊名：WORLD JOURNAL OF SURGICAL ONCOLOGY

收录：;Scopus(收录号：2-s2.0-85150145445);WOS:【SCI-EXPANDED(收录号:WOS:000948453200001)】；

语种：英文

外文关键词：Anterior mediastinal tumor; Laryngeal mask anesthesia; Lateral thoracic approach; Robot-assisted thoracic surgery; Subxiphoid approach

摘要：BackgroundThe purpose of this study was to compare the perioperative efficacy and safety of da Vinci robot-assisted thoracoscopic surgery (RATS) for treating anterior mediastinal tumors through the subxiphoid and lateral thoracic approaches under the anesthesia of nontracheal intubation (i.e., laryngeal mask airway).MethodsWe retrospectively analyzed the clinical data of 116 patients with anterior mediastinal tumors treated by RATS under laryngeal mask anesthesia completed by the same operator in the Department of Thoracic Surgery, Gansu Provincial People's Hospital, from October 2016 to October 2022. There were a total of 52 patients including 24 males and 28 females, with an average age of 45.40 +/- 4.94 years, in the subxiphoid approach (subxiphoid group). On the other hand, there were a total of 64 patients including 34 males and 30 females, with a mean age of 46.86 +/- 5.46 years in the lateral thoracic approach (lateral thoracic group). Furthermore, we have detailedly compared and analyzed the operating time, intraoperative bleeding, and total postoperative drainage in the two groups.ResultsAll patients in both groups successfully completed resection of the anterior mediastinal tumor without occurring perioperative death. Compared with the lateral thoracic group, the subxiphoid group has more advantages in terms of total postoperative drainage (P=0.035), postoperative drainage time (P=0.015), postoperative hospital stay (P=0.030), and visual analog scale (VAS) pain on postoperative days 2 (P=0.006) and 3 (P=0.002). However, the lateral thoracic group has more advantages in the aspect of docking time (P=0.020). There was no statistically significant difference between the two groups in terms of operative time (P=0.517), total operative time (P=0.187), postoperative day 1 VAS pain score (P=0.084), and postoperative complications (P=0.715).ConclusionThe subxiphoid approach of RATS under laryngeal mask anesthesia is safe and feasible for resecting anterior mediastinal tumors. Compared with the lateral thoracic approach, the subxiphoid approach has advantages in terms of rapid postoperative recovery and postoperative patient pain, and patient acceptance is also higher and thus is worth promoting in hospitals where it is available.