Comparison of efficacy of da Vinci robot-assisted thoracoscopic surgery in treatment of anterior mediastinal tumors via subxiphoid approach and lateral thoracic intercostal approach
PEI Shimin
ZHOU Yifan
SHEN Bin
HUANG Jianwei
ZHANG Chen
Abstract：Objective To compare the efficacy of da Vinci robot-assisted thoracoscopic surgery(RATS)in treatment of anterior mediastinal tumors via subxiphoid approach and lateral thoracic intercostal approach.Methods A retrospective analysis was conducted on the clinical data of 50 patients who underwent RATS for anterior mediastinal tumor resection in the People's Hospital of Guangxi Zhuang Autonomous Region from July 2021 to June 2025.According to the surgical approaches,the patients were divided into subxiphoid approach group(n=30)and lateral thoracic intercostal approach group(n=20).The baseline data,perioperative indicators,postoperative hospital stay,total hospitalization cost and the incidence of postoperative complications were compared between the two groups.Results All the patients'operations were successfully completed.Compared with the subxiphoid approach group,the lateral thoracic intercostal approach group had significantly shorter durations of operation and postoperative drainage tube retention(P＜0.05),and significantly less intraoperative blood loss(P＜0.05).However,there were no statistically significant differences in postoperative 48-hour drainage volume,and in Visual Analogue Scale(VAS)scores,C-reactive protein(CRP)level and white blood cell count on the first day after operation between the two groups(P＞0.05).The postoperative hospital stay of the lateral thoracic intercostal approach group was significantly shorter than that of the subxiphoid approach group(P＜0.05),but there was no statistically significant difference in the total hospitalization cost between the two groups(P＞0.05).There was no statistically significant difference in the incidence of complications between the two groups(P＞0.05).Conclusion Compared with RATS via the subxiphoid approach,RATS via the lateral thoracic intercostal approach can shorten durations of operation and postoperative drainage tube retention,and postoperative hospital stay,and reduce intraoperative blood loss in treatment of anterior mediastinal tumors,and the surgical effect of RATS via the lateral thoracic intercostal approach is more advantageous.
Keywords：Robot-assisted thoracoscopic surgerySubxiphoid approachLateral thoracic intercostal approachAnterior mediastinal tumors
Publication Date：2025-10-30
Online Publishing Date：2025-11-13(First online date of this platform, not the publication date of the document)
Pages：5( 1092-1096 )