Abstract:

Objective To compare the clinical effects of the subxiphoid approach and the intercostal approach for thoracoscopy for anterior mediastinal lesions. Methods Consecutive patients with anterior mediastinal surgery from January 2020 to May，2021 at Yichang Central People′s Hospital were retrospectively enrolled in the study. A total of 124 cases were included in the study. Sixty-three patients received the thoracoscopy via subxiphoid approach were assigned as one group and the other 61 via the intercostal approach as the other group. The clinical， pathological，and perioperative data of the two groups were collected. Statistical analyses were performed using SPSS version 22.0. Results There were no significant differences in blood loss，drainage volume，time of drainage intubation，conversion rate to thoracotomy，white blood cell value and CRP value after operation，length of hospital stay，hospitalization cost and complications between the two groups. The operation time of the subxiphoid approach group was higher than the intercostal approach group（P < 0.05）. VAS score and ratio of drainage intubation in the subxiphoid approach group were significantly lower than those in the intercostal approach group（P < 0.01）. Conclusion Both approaches for thoracoscopy are safe and effective in treating anterior mediastinal lesions. The subxiphoid approach is superior to the intercostal approach for its less damage to the intercostal nerve，less pain， no need for drainage intubation，thereby worthy of spreading clinically.

Key words:

mediastinal tumor, video?assisted thoracoscopic surgery, subxiphoid