E. A. Epifantsev, A. V. Smirnov, V. Gritsun, A. Keshvedinova, Yu. V. Ivanov
{"title":"使用单孔和三孔胸腔镜胸腺切除术治疗无创上皮性胸腺肿瘤的即时效果比较分析","authors":"E. A. Epifantsev, A. V. Smirnov, V. Gritsun, A. Keshvedinova, Yu. V. Ivanov","doi":"10.17709/2410-1893-2023-10-4-6","DOIUrl":null,"url":null,"abstract":"Purpose of the study. Evaluation of the safety and effectiveness of single-port thoracoscopic thymectomy in comparison with traditional three-port thymectomy in patients with stage I and II thymic epithelial tumors.Patients and methods. The results of 50 thoracoscopic thymectomies performed from January 2019 to May 2023 on patients with stage I and II thymic epithelial tumors without the presence of myasthenia were analyzed. The age of the patients ranged from 20 to 75 years, with a median of 44 years. There were 28 (56 %) women, 22 (44 %) men. The minimum size of the removed thymoma in the study was 20 mm, the maximum was 165 mm. Out of the 50 patients who underwent singleand three-port thoracoscopic thymectomy, 42 (84 %) had tumor diameters of 70 mm or less, and 8 (16 %) had tumor diameters greater than 70 mm. Tumor size was significantly larger in the three-port thymectomy group (43 mm [35 mm; 55 mm] vs. 60 mm [38 mm; 78 mm], p = 0.044).Results. The analysis noted a statistically significant increase in the duration of the operation in the group of three-port thoracoscopic thymectomies (duration of operations – 107.5 minutes [70 minutes; 132.5 minutes] versus 70.0 minutes [57 minutes; 79 minutes] in the group with a single-port approach). A statically significant result was also obtained in terms of drainage of pleural cavity drainage and, as a consequence, in duration of postoperative bed rest. Patients operated through a single-port approach stayed in the hospital for 3 to 5 days on average (4.0 days), while those with a three-port approach stayed from 3 to 13 days on average (5.0 days). A comparative analysis revealed a significant reduction in the length of hospital stay in patients who underwent single-port thoracoscopic thymectomy, in contrast to those undergoing three-port surgical interventions.Conclusion. This study is the first in Russia to compare oneand three-port techniques for removing thymic tumors in a number of patients sufficient for statistical calculations. It has been shown that for thymic tumors up to 5 cm, single-port thoracoscopic thymectomy compared to three-port does not lead to prolongation of the operation or an increase in intraand postoperative complications. Therefore, in our opinion, it is the preferable option.","PeriodicalId":334809,"journal":{"name":"Research and Practical Medicine Journal","volume":"13 7","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative analysis of the immediate results of thoracoscopic thymectomy using single-port and three-port approaches in the treatment of non-invasive epithelial thymic tumors\",\"authors\":\"E. A. Epifantsev, A. V. Smirnov, V. Gritsun, A. Keshvedinova, Yu. V. Ivanov\",\"doi\":\"10.17709/2410-1893-2023-10-4-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Purpose of the study. Evaluation of the safety and effectiveness of single-port thoracoscopic thymectomy in comparison with traditional three-port thymectomy in patients with stage I and II thymic epithelial tumors.Patients and methods. The results of 50 thoracoscopic thymectomies performed from January 2019 to May 2023 on patients with stage I and II thymic epithelial tumors without the presence of myasthenia were analyzed. The age of the patients ranged from 20 to 75 years, with a median of 44 years. There were 28 (56 %) women, 22 (44 %) men. The minimum size of the removed thymoma in the study was 20 mm, the maximum was 165 mm. Out of the 50 patients who underwent singleand three-port thoracoscopic thymectomy, 42 (84 %) had tumor diameters of 70 mm or less, and 8 (16 %) had tumor diameters greater than 70 mm. Tumor size was significantly larger in the three-port thymectomy group (43 mm [35 mm; 55 mm] vs. 60 mm [38 mm; 78 mm], p = 0.044).Results. The analysis noted a statistically significant increase in the duration of the operation in the group of three-port thoracoscopic thymectomies (duration of operations – 107.5 minutes [70 minutes; 132.5 minutes] versus 70.0 minutes [57 minutes; 79 minutes] in the group with a single-port approach). A statically significant result was also obtained in terms of drainage of pleural cavity drainage and, as a consequence, in duration of postoperative bed rest. Patients operated through a single-port approach stayed in the hospital for 3 to 5 days on average (4.0 days), while those with a three-port approach stayed from 3 to 13 days on average (5.0 days). A comparative analysis revealed a significant reduction in the length of hospital stay in patients who underwent single-port thoracoscopic thymectomy, in contrast to those undergoing three-port surgical interventions.Conclusion. This study is the first in Russia to compare oneand three-port techniques for removing thymic tumors in a number of patients sufficient for statistical calculations. It has been shown that for thymic tumors up to 5 cm, single-port thoracoscopic thymectomy compared to three-port does not lead to prolongation of the operation or an increase in intraand postoperative complications. Therefore, in our opinion, it is the preferable option.\",\"PeriodicalId\":334809,\"journal\":{\"name\":\"Research and Practical Medicine Journal\",\"volume\":\"13 7\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-11-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Research and Practical Medicine Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.17709/2410-1893-2023-10-4-6\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research and Practical Medicine Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17709/2410-1893-2023-10-4-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Comparative analysis of the immediate results of thoracoscopic thymectomy using single-port and three-port approaches in the treatment of non-invasive epithelial thymic tumors
Purpose of the study. Evaluation of the safety and effectiveness of single-port thoracoscopic thymectomy in comparison with traditional three-port thymectomy in patients with stage I and II thymic epithelial tumors.Patients and methods. The results of 50 thoracoscopic thymectomies performed from January 2019 to May 2023 on patients with stage I and II thymic epithelial tumors without the presence of myasthenia were analyzed. The age of the patients ranged from 20 to 75 years, with a median of 44 years. There were 28 (56 %) women, 22 (44 %) men. The minimum size of the removed thymoma in the study was 20 mm, the maximum was 165 mm. Out of the 50 patients who underwent singleand three-port thoracoscopic thymectomy, 42 (84 %) had tumor diameters of 70 mm or less, and 8 (16 %) had tumor diameters greater than 70 mm. Tumor size was significantly larger in the three-port thymectomy group (43 mm [35 mm; 55 mm] vs. 60 mm [38 mm; 78 mm], p = 0.044).Results. The analysis noted a statistically significant increase in the duration of the operation in the group of three-port thoracoscopic thymectomies (duration of operations – 107.5 minutes [70 minutes; 132.5 minutes] versus 70.0 minutes [57 minutes; 79 minutes] in the group with a single-port approach). A statically significant result was also obtained in terms of drainage of pleural cavity drainage and, as a consequence, in duration of postoperative bed rest. Patients operated through a single-port approach stayed in the hospital for 3 to 5 days on average (4.0 days), while those with a three-port approach stayed from 3 to 13 days on average (5.0 days). A comparative analysis revealed a significant reduction in the length of hospital stay in patients who underwent single-port thoracoscopic thymectomy, in contrast to those undergoing three-port surgical interventions.Conclusion. This study is the first in Russia to compare oneand three-port techniques for removing thymic tumors in a number of patients sufficient for statistical calculations. It has been shown that for thymic tumors up to 5 cm, single-port thoracoscopic thymectomy compared to three-port does not lead to prolongation of the operation or an increase in intraand postoperative complications. Therefore, in our opinion, it is the preferable option.