PMID- 32190357
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220413
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 12
IP  - 2
DP  - 2020 Feb
TI  - Trans-subxiphoid robotic surgery for anterior mediastinal disease: an initial 
      case series.
PG  - 82-88
LID - 10.21037/jtd.2019.07.38 [doi]
AB  - BACKGROUND: Video-assisted thoracoscopic trans-subxiphoid surgery is an ideal 
      technique for removing anterior mediastinal lesions. The diffusion of this 
      method, however, has been limited by the complexity of surgical maneuvers to be 
      performed in the narrow retrosternal space. Robotic surgery holds promise to 
      overcome the technical limitations of the thoracoscopic trans-subxiphoid 
      approach. Here, we describe a case series of patients who had undergone 
      trans-subxiphoid robotic surgery-with a special focus on short-term outcomes. 
      METHODS: Between January 2018 and January 2019, a total of 20 patients underwent 
      trans-subxiphoid robotic surgery for maximal thymectomy or removal of anterior 
      mediastinal masses. A 3-cm longitudinal incision was performed below the xiphoid 
      process, through which carbon dioxide was insufflated and a camera port was 
      inserted. Subsequently, the lower sections of the mediastinal pleura were 
      detached bilaterally-followed by the creation of two bilateral 1-cm skin 
      incisions on the anterior axillary line in the sixth intercostal space for the 
      insertion of robotic arms. Upon completion of port positioning, the surgical 
      robot was docked. RESULTS: All robotic surgery procedures were successfully 
      completed. Neither conversion to open surgery nor the creation of additional 
      ports was required. The median operating time and console time were 118 min 
      [interquartile range (IQR): 84-147 min] and 92.5 min (IQR: 78.5-133.5 min), 
      respectively. Drainage tube positioning was not required in 11 (55%) patients. 
      There were no operative deaths, and the median length of postoperative hospital 
      stay was 2.5 days (IQR: 2-3 days). One patient had postoperative chylothorax and 
      received conservative treatment. CONCLUSIONS: The results of this case series 
      provide initial support to the clinical feasibility, safety, and short-term 
      positive outcomes of trans-subxiphoid robot-assisted surgery for anterior 
      mediastinal disease.
CI  - 2020 Journal of Thoracic Disease. All rights reserved.
FAU - Leow, Osbert Qi Yao
AU  - Leow OQY
AD  - Department of Surgery, Chang Gung Memorial Hospital-Linko, Taoyuan.
FAU - Cheng, Chuan
AU  - Cheng C
AD  - Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linko, Chang Gung 
      University, Taoyuan.
FAU - Chao, Yin-Kai
AU  - Chao YK
AD  - Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linko, Chang Gung 
      University, Taoyuan.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC7061188
OTO - NOTNLM
OT  - Mediastinal disease
OT  - robot-assisted surgery
OT  - thymectomy
OT  - trans-subxiphoid approach
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2020/03/20 06:00
MHDA- 2020/03/20 06:01
PMCR- 2020/02/01
CRDT- 2020/03/20 06:00
PHST- 2020/03/20 06:00 [entrez]
PHST- 2020/03/20 06:00 [pubmed]
PHST- 2020/03/20 06:01 [medline]
PHST- 2020/02/01 00:00 [pmc-release]
AID - jtd-12-02-82 [pii]
AID - 10.21037/jtd.2019.07.38 [doi]
PST - ppublish
SO  - J Thorac Dis. 2020 Feb;12(2):82-88. doi: 10.21037/jtd.2019.07.38.