Same-day discharge for patients undergoing subxiphoid thoracoscopic thymectomy for small tumours without myasthenia gravis: a prospective, single-arm clinical trial.

Objectives: Subxiphoid thoracoscopic surgery is an effective method for treating thymic tumours. We performed the first evaluation of the safety and feasibility of same-day discharge (SDD) in patients undergoing this procedure and summarized their associated clinical experience.

Methods: We conducted a single-arm, single-centre prospective clinical trial. This study was registered at www.chictr.org.cn (ChiCTR2300077148). The subjects were patients with a preoperative clinical diagnosis of thymic tumour. All eligible patients underwent examinations and preparations at the preoperative preparation centre and subsequently underwent a subxiphoid thoracoscopic thymectomy. The evaluation indicators included R0 (complete resection without residual tumour) resection rate, SDD completion rate, 30-day postoperative readmission rate, number of emergency visits, perioperative complication rate, length of stay and total medical costs.

Results: A total of 39 patients were enrolled between November 2023 and April 2024. All patients underwent subxiphoid thoracoscopic resection of the thymic tumours to achieve R0 resection. The completion rate of the SDD surgery was 92.3% (36/39). The perioperative complication rate was 5.6% (2/36 patients). Only 2.8% (1/36) of the patients were readmitted within 1 month of an emergency visit due to pneumothorax. The median length of stay was 11 h (interquartile range 10-14), and the median total medical cost was 19 400 renminbi (interquartile range 18 500-21 100).

Conclusions: The SDD procedure may be safe and feasible for selected patients undergoing subxiphoid thoracoscopic thymectomy, based on a small sample size. Large-scale studies are needed to confirm these preliminary findings.