Single-port video-assisted thoracoscopic mediastinal tumour resection

To present the technique of single-port video-assisted thoracoscopic mediastinal tumour resection, which includes limited thymectomy, extended thymectomy, cyst excision and posterior mediastinal tumour excision, and the early results of resection with the use of this technique.

Twenty-nine patients with mediastinal tumours were treated with single-port thoracoscopic mediastinal resection at Chung Gung Memorial Hospital between April 2014 and May 2015.The surgical intervention was performed through the fourth or fifth intercostal space at the anterior axillary line. A 5- or 10-mm 30° video camera and working instruments were employed simultaneously at this incision site throughout the surgery. The perioperative variables and outcomes were collected and analysed retrospectively.

Among the 29 cases included in the final analysis, 8 extended thymectomies, 5 limited thymectomies, 7 cyst excisions and 9 tumour excisions were performed successfully without the need for conversion. For the 29 patients who underwent single-port video-assisted thoracoscopic surgery (VATS), the mean operation time was 97.3 ± 31.2 min and the average blood loss was 34.1 ± 45.7 ml. The average length of the incision wound was 3.41 ± 0.76 cm and the average length of postoperative hospital stay was 3.75 ± 1.53 days. There were no mortalities, and mobility was achieved 30 days after surgery.

With regard to oncological concerns, the occurrence of postoperative myasthenia gravis or freedom from tumour recurrence is a paramount issue. Our cohort follow-up time was not long enough to address this, and more time and patients are needed for further evaluation. But our preliminary report showed that uniportal VATS for mediastinal tumour resection was a promising and safe technique with regard to short-term clinical outcome.