Background: In recent years, with the advancement of minimally invasive techniques, thoracoscopic thymoma resection has experienced a development process from three-port video-assisted thoracic surgery (VATS) to two-port (TP) and single-port (SP) variants. However, the feasibility and safety of SP-VATS have not been generally recognized. This study intends to explore the safety and feasibility of SP-VATS in thymoma resection, in order to provide a reference for clinical surgicalselection.
Methods: The clinical data of 197 patients who underwent thoracoscopic thymoma resection in Beijing Tongren Hospital from January 2018 to September 2021 were retrospectively analyzed. The patients were divided into SP-VATS group (n=42) and TP-VATS group (n=155). After matching propensity scores, there is no statistically significant difference in preoperative baseline data between SP-VATS group and TP-VATS group. Among them, there were 17 males and 25 females with an average age of 28-72 (48.00±9.43) years in the SP-VATS group, and 20 males and 22 females with an average age of 30-75 (50.38±9.83) years in TP-VATS group. The clinical effects of the two groups were compared.
Results: The operation was successfully completed in both groups, and there was no conversion to thoracotomy or increased surgical incisions. Compared with the TP-VATS group, the chest drainage time and hospital stay in the SP-VATS group were shorter [(2.95±0.76) d vs (3.33±0.85) d; (4.57±0.83) d vs (5.07±1.13) d], and the visual pain score at 24 h and 72 h after surgery were lower [(3.64±0.85) points vs (4.05±0.66) points; (2.33±0.75) points vs (3.07±0.68) points] (P<0.05). There was no statistically significant difference between the two groups in operation time [(130.00±26.23) min vs (135.24±27.03) min], intraoperative blood loss [(69.52±22.73) mL vs (82.38±49.23) mL] (P>0.05).
Conclusions: SP-VATS in thymoma is a safe, feasible, and less invasive procedure, with less postoperative pain and faster recovery than multi-port VATS.
【中文题目：单孔与单操作孔胸腔镜下胸腺瘤切除术的 临床疗效比较：一项倾向性评分匹配研究】 【中文摘要：背景与目的 近年来随着临床微创技术的不断进步，胸腔镜胸腺瘤切除术经历了从三孔操作到单操作孔、单孔的发展历程。然而，单孔胸腔镜技术的可行性及安全性尚未得到普遍认可。本研究拟探讨单孔胸腔镜手术在胸腺瘤切除中的安全性与可行性，以期为临床手术方式的选择提供参考。方法 回顾性分析2018年1月-2021年9月在北京同仁医院接受胸腔镜胸腺瘤切除手术治疗的197例患者的临床资料。按照手术方式将患者分为单孔胸腔镜胸腺瘤切除组（单孔组，n=42）和单操作孔胸腔镜胸腺瘤切除组（单操作孔组，n=155）。经倾向性评分匹配，单操作孔组获得与单孔组术前基线资料具有可比性的42例患者，其中单孔组男性17例、女性25例，年龄28-72（48.00±9.43）岁；单操作孔组男性20例、女性22例，年龄30-75（50.38±9.83）岁。对比两组的临床疗效。结果 两组均顺利完成手术，均无中转开胸或增加手术切口。单孔组和单操作孔组比较，胸腔引流时间和住院时间更短［(2.95±0.76) d vs (3.33±0.85) d; (4.57±0.83) d vs (5.07±1.13) d］，术后24 h及72 h视觉疼痛评分更低［（3.64±0.85）分 vs （4.05±0.66）分；（2.33±0.75）分 vs （3.07±0.68）分]，差异有统计学意义（P<0.05）。单孔组、单操作孔组在手术时间[(130.00±26.23) min vs (135.24±27.03) min]、术中出血量[(69.52±22.73) mL vs (82.38±49.23) mL]等方面差异无统计学意义（P>0.05）。结论 单孔胸腔镜胸腺瘤切除术是一种安全、可行、更微创的术式，术后疼痛较多孔胸腔镜手术减轻，恢复更快。 】 【中文关键词：单孔；胸腺瘤；胸腔镜；倾向性评分匹配】.
Keywords: Propensity-score matching; Single-port; Thymoma; Video-assisted thoracoscopic surgery.