Skip to main content

ORIGINAL RESEARCH article

Front. Surg.
Sec. Thoracic Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1463881
This article is part of the Research Topic Surgical Treatment of Thymic Epithelial Tumor and Myasthenia Gravis View all 4 articles

Choosing the Proper Path: Outcomes of Subxiphoid vs Lateral Intercostal Approaches in the Resection of Anterior Mediastinal Masses

Provisionally accepted
Xuechun Leng Xuechun Leng 1Mengzhou Chen Mengzhou Chen 1,2Yang Zhang Yang Zhang 1,2Jian Gao Jian Gao 1Zhenbing You Zhenbing You 1Zhongwu Hu Zhongwu Hu 1,2*
  • 1 Huai'an First People's Hospital, Huai'an, Jiangsu, China
  • 2 Huai'an City, Jiangsu Province, Huaian, China

The final, formatted version of the article will be published soon.

    Background: While the subxiphoid approach (SA) in thoracoscopic thymectomy offers benefits in terms of fat removal and pain reduction, it remains unclear which patients with anterior mediastinal masses benefit most from the subxiphoid versus the lateral intercostal approach (LA).Methods: This retrospective study analyzed patients treated for anterior mediastinal masses at our center from January 2019 to December 2023. Patients were categorized into two groups based on the surgical approach: SA (35 cases) and LA (56 cases). Demographic data, clinical characteristics, perioperative metrics, and short-term outcomes were compared.Results: Ninety-one patients were included, with diagnoses including thymic cysts (43), thymomas types A, AB, and B1 (24), B2 thymomas (18), thymic carcinoma (6).No significant differences were found between the groups in terms of gender, age, tumor size, body mass index, conversion to sternotomy, or blood loss. The LA group, however, experienced shorter surgical durations (P < 0.001), less drainage (P = 0.021), shorter hospital stays (P < 0.001), and lower hospitalization costs (P = 0.024). Pain scores on the visual analogue scale were similar between groups on the day of surgery and the first postoperative day.The findings suggest that the lateral intercostal approach is preferable for patients with thymic cysts and Masaoka stage I-II thymomas without myasthenia gravis due to its efficiency and cost-effectiveness.

    Keywords: lateral intercostal approach, Video-assisted thoracoscopic surgery (VATS), Anterior mediastinal mass, Short-term efficacy, Lq

    Received: 12 Jul 2024; Accepted: 19 Nov 2024.

    Copyright: © 2024 Leng, Chen, Zhang, Gao, You and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zhongwu Hu, Huai'an City, Jiangsu Province, Huaian, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.