Clinical efficacy of thoracoscopic surgery by subxiphoid approach for thymoma and its influence on intraoperative blood loss and postoperative complications

Peng Shen; Quan Chen; Fengwei Zhu; Shouqi Tang; Xuxian Zhang; Feng Li

Clinical efficacy of thoracoscopic surgery by subxiphoid approach for thymoma and its influence on intraoperative blood loss and postoperative complications

Am J Transl Res. 2021 Nov 15;13(11):12843-12851. eCollection 2021.

Authors

Peng Shen¹, Quan Chen², Fengwei Zhu³, Shouqi Tang³, Xuxian Zhang¹, Feng Li²

Affiliations

¹ Department of Chest Surgery, Dongping Hospital Affiliated to Shandong First Medical University Dongping 271500, Shandong, China.
² Department of Oncology, Dongping Hospital Affiliated to Shandong First Medical University Dongping 271500, Shandong, China.
³ Department of General Surgery, Dongping Hospital Affiliated to Shandong First Medical University Dongping 271500, Shandong, China.

PMID: 34956499
PMCID: PMC8661206

Abstract

Objective: To evaluate the clinical efficacy of thoracoscopic surgery by subxiphoid approach for patients with thymoma and its influence on intraoperative blood loss and postoperative complications.

Methods: From January 2019 to January 2020, 90 patients who underwent thoracoscopic surgery were enrolled and evenly divided into a control group receiving surgery by lateral thoracic approach and an experimental group adopting the subxiphoid approach according to different surgical approaches, and their clinical data were retrospectively analyzed. The clinical efficacy, perioperative indexes, postoperative complications, pulmonary function, and inflammatory factors were compared between the two groups. Generic Quality of Life Inventory-74 (GQOLI-74) was used to assess the quality of life of the patients before and after surgery, and Mini-Mental State Examination (MMSE) was used to assess their mental state. The Numerical Rating Scale (NRS) was used to evaluate the postoperative pain of the two groups.

Results: After treatment, the total clinical effectiveness rate of the experimental group was significantly higher than that of the control group (P<0.05). The experimental group obtained superior results in perioperative index and fewer postoperative complications compared with the control group (P<0.05). Better performance of FEV1 and FVC was observed in the experimental group than the control group (P<0.05). The experimental group had significantly higher postoperative GQOLI-74 scores (P<0.001) and MMSE scores (P<0.05) than the control group. Lower levels of C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α), and lower NRS scores at 12 h and 24 h after surgery were witnessed in the experimental group compared to the control group (P<0.05).

Conclusion: For patients with thymoma, the thoracoscopic surgery by subxiphoid approach is safe and effective, and can reduce the intraoperative blood loss and postoperative complications.

Keywords: Subxiphoid approach; clinical efficacy; postoperative complications; thymoma.