PMID- 27807708
OWN - NLM
STAT- MEDLINE
DCOM- 20171109
LR  - 20220317
IS  - 1432-2323 (Electronic)
IS  - 0364-2313 (Linking)
VI  - 41
IP  - 3
DP  - 2017 Mar
TI  - The Subxiphoid Approach Leads to Less Invasive Thoracoscopic Thymectomy Than the 
      Lateral Approach.
PG  - 763-770
LID - 10.1007/s00268-016-3783-8 [doi]
AB  - OBJECTIVE: Video-assisted thoracic surgery (VATS) is widely used in thoracic 
      surgery. This study investigated the usefulness of the subxiphoid approach in 
      thymectomy using VATS techniques. METHODS: Sixty operations were performed using 
      the lateral approach (n = 46) and subxiphoid approach (n = 14). Using the lateral 
      approach, 39 partial thymectomies (PT), 5 total or subtotal thymectomies (TT), 
      and 2 total or subtotal thymectomies with combined resection of the surrounding 
      organs (or tissues) (CR) were performed. Using the subxiphoid approach, 11 TT and 
      3 CR were performed. RESULTS: There were 33 females and 27 males, with a mean age 
      of 55 years. The mean maximum tumor diameter was 4.0 cm. The operation time was 
      prolonged according to the volume of thymectomy (PT: 119, TT: 234, CR: 347 min). 
      Additionally, the intraoperative blood loss increased according to the volume of 
      thymectomy (PT: 29, TT: 47, CR: 345 g). To compare the invasiveness of both 
      approaches, we compared 16 TT operations. In the group using the subxiphoid 
      approach, the operation time became shorter (158 vs. 392 min), and the blood loss 
      decreased (5 vs. 135 g) compared with the lateral approach. Regarding laboratory 
      data, white blood cell counts on postoperative day 1 (1POD) (8200 vs. 10,300/mul) 
      and CRP on 1POD and 3POD (2.8 and 2.8 vs. 7.9 and 10.2 mg/dl, respectively) 
      decreased in the subxiphoid approach compared with the lateral approach. 
      CONCLUSIONS: The subxiphoid approach leads to a less invasive operation for 
      anterior mediastinal tumors and extends the indications for VATS for invasive 
      anterior mediastinal tumors.
FAU - Yano, Motoki
AU  - Yano M
AD  - Division of Chest Surgery, Department of Surgery, Aichi Medical University, 1-1 
      Yazakokarimata, Nagakute, 480-1195, Japan. motoki2ds@yahoo.co.jp.
FAU - Moriyama, Satoru
AU  - Moriyama S
AD  - Department of Oncology, Immunology and Surgery, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Haneda, Hiroshi
AU  - Haneda H
AD  - Department of Oncology, Immunology and Surgery, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Okuda, Katsuhiro
AU  - Okuda K
AD  - Department of Oncology, Immunology and Surgery, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Kawano, Osamu
AU  - Kawano O
AD  - Department of Oncology, Immunology and Surgery, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Oda, Risa
AU  - Oda R
AD  - Department of Oncology, Immunology and Surgery, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Suzuki, Ayumi
AU  - Suzuki A
AD  - Department of Oncology, Immunology and Surgery, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Nakanishi, Ryoichi
AU  - Nakanishi R
AD  - Department of Oncology, Immunology and Surgery, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Numanami, Hiroki
AU  - Numanami H
AD  - Division of Chest Surgery, Department of Surgery, Aichi Medical University, 1-1 
      Yazakokarimata, Nagakute, 480-1195, Japan.
FAU - Haniuda, Masayuki
AU  - Haniuda M
AD  - Division of Chest Surgery, Department of Surgery, Aichi Medical University, 1-1 
      Yazakokarimata, Nagakute, 480-1195, Japan.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Blood Loss, Surgical
MH  - C-Reactive Protein/analysis
MH  - Female
MH  - Humans
MH  - Leukocyte Count
MH  - Male
MH  - Mediastinal Neoplasms/*surgery
MH  - Middle Aged
MH  - Operative Time
MH  - Postoperative Period
MH  - Retrospective Studies
MH  - Thoracic Surgery, Video-Assisted/*methods
MH  - Thymectomy/*methods
MH  - Young Adult
EDAT- 2016/11/04 06:00
MHDA- 2017/11/10 06:00
CRDT- 2016/11/04 06:00
PHST- 2016/11/04 06:00 [pubmed]
PHST- 2017/11/10 06:00 [medline]
PHST- 2016/11/04 06:00 [entrez]
AID - 10.1007/s00268-016-3783-8 [pii]
AID - 10.1007/s00268-016-3783-8 [doi]
PST - ppublish
SO  - World J Surg. 2017 Mar;41(3):763-770. doi: 10.1007/s00268-016-3783-8.