A comparative study on the clinical efficacy of modified subxiphoid and subcostal incision procedure and inflatable subxiphoid approach for thymic tumor resection

MA Xingang; YUAN Xin; WANG Yanbing; CHEN Xiaofeng; YAN Yingguang; WANG Xingang

doi:10.3969/j.issn.1674-3806.2025.06.17

Abstract：Objective To compare the clinical efficacy of modified subxiphoid and subcostal incision procedure and inflatable subxiphoid approach for thymic tumor resection.Methods The clinical data of 80 patients with thymic tumors who were admitted to Baoding No.2 Central Hospital from June 2021 to February 2024 were retrospectively analyzed.According to different treatment methods,the patients were divided into control group(undergoing inflatable subxiphoid approach for thymic tumor resection,38 cases)and observation group(undergoing modified subxiphoid and subcostal incision procedure for thymic tumor resection,42 cases).The operation-related indicators,pulmonary function indicators,inflammatory indicators,postoperative Visual Analogue Scale(VAS)scores,the number of compressions of the analgesic pump,clinical efficacy and the occurrence of postoperative adverse reactions were compared between the two groups.Results The operation time,time of postoperative indwelling catheter and length of stay in hospital in the observation group were shorter than those in the control group,and the intraoperative blood loss and postoperative drainage volume in the observation group were less than those in the control group,with statistically significant differences between the two groups(P＜0.05).The levels of forced vital capacity(FVC)and forced expiratory volume in 1 second(FEV1)after operation in the observation group were higher than those in the control group,and the levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),and interleukin-6(IL-6)after operation in the observation group were lower than those in the control group,with statistically significant differences between the two groups(P＜0.05).At 4 hours and 24 hours after operation,the VAS scores in the observation group were lower than those in the control group,and the number of compressions of the analgesic pump after operation in the observation group was less than that in the control group,with statistically significant differences between the two groups(P＜0.05).The total clinical effective rate of the observation group was significantly higher than that of the control group(90.48％vs 73.68％;x2=3.869,P=0.048),and the incidence of postoperative adverse reactions in the observation group was significantly lower than that in the control group(7.14％vs 23.68％;x2=4.281,P=0.038).Conclusion Compared with the inflatable subxiphoid approach,the modified subxiphoid and subcostal incision procedure has less intraoperative blood loss,faster recovery for the patients,higher total clinical effective rate,and lower incidence of adverse reactions in resection of thymic tumors.The modified subxiphoid and subcostal incision procedure is worthy of clinical recommendation.