초록접수 현황
| 20F-147 | 구연 발표 |
Early outcomes of VATS Thymectomy via Subxiphoid approach
Sukki Cho, Woohyun Jung, Soyoung Lee, Wan Jin Hwang, Beatrice Chia-Hui Shih
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : This study is to evaluate early outcomes of VATS thymectomy via subxiphoid (ST) comparing with VATS thymectomy via intercostal space (VT).
Methods : From 2011 to 2020, 100 patients underwent VATS thymectomy for thymic abnormalities such as thymoma or thymic cyst. Among them, 35 patients were operated on via the subxiphoid approach (ST) and the others 65 via the conventional right-side or bilateral intercostal approach (VT). The clinical outcomes were retrospectively reviewed and compared.
Results : Compared with VT, patients by ST was significantly older, however incidence of thymoma and MG was not different. The mean operation time was not different between two groups (100 min of ST, 118 min of VT). The length of hospital stay was similar, mean days were around 3 days. In terms of pain score, pain score of operation day or postoperative 1 day was not different, however that of postoperative 2 and 3 days was significantly lower in ST group. During follow up, 16 patients (25%) of VT group complained of persistent pain even after 1 month of surgery. Complications were as follows; in ST group, persistent air leak (> 5days) and MG crisis in each 1 patient; in VT group, intraoperative bleeding in 3 patients (converted to open thoracotomy in 2 patients), chylothorax, left phrenic palsy, and MG crisis in each 1 patient.
Conclusion : The VATS thymectomy via subxiphoid approach showed comparable outcome of operation time and length of hospital stay. In terms of postoperative pain and complication rate, subxiphoid approach was better than intercostal approach.
Methods : From 2011 to 2020, 100 patients underwent VATS thymectomy for thymic abnormalities such as thymoma or thymic cyst. Among them, 35 patients were operated on via the subxiphoid approach (ST) and the others 65 via the conventional right-side or bilateral intercostal approach (VT). The clinical outcomes were retrospectively reviewed and compared.
Results : Compared with VT, patients by ST was significantly older, however incidence of thymoma and MG was not different. The mean operation time was not different between two groups (100 min of ST, 118 min of VT). The length of hospital stay was similar, mean days were around 3 days. In terms of pain score, pain score of operation day or postoperative 1 day was not different, however that of postoperative 2 and 3 days was significantly lower in ST group. During follow up, 16 patients (25%) of VT group complained of persistent pain even after 1 month of surgery. Complications were as follows; in ST group, persistent air leak (> 5days) and MG crisis in each 1 patient; in VT group, intraoperative bleeding in 3 patients (converted to open thoracotomy in 2 patients), chylothorax, left phrenic palsy, and MG crisis in each 1 patient.
Conclusion : The VATS thymectomy via subxiphoid approach showed comparable outcome of operation time and length of hospital stay. In terms of postoperative pain and complication rate, subxiphoid approach was better than intercostal approach.
책임저자: Sukki Cho
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Sukki cho, E-mail : skcho@snubh.org