[Single-versus Two-port Video-assisted Thoracic Surgery in Thymoma: 
A Propensity-matched Study]

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Advancements in minimally invasive techniques have led to the development of single-port (SP) and two-port (TP) video-assisted thoracic surgery (VATS) for thymoma resection.
• The clinical acceptance and validation of SP-VATS for thymoma removal remain areas of ongoing investigation.

Purpose of the Study:

• To evaluate the safety and feasibility of single-port VATS (SP-VATS) compared to multi-port VATS (TP-VATS) for thymoma resection.
• To provide data to inform clinical decision-making regarding surgical approach selection for thymoma treatment.

Main Methods:

• Retrospective analysis of 197 patients undergoing thoracoscopic thymoma resection between January 2018 and September 2021.
• Patients were categorized into SP-VATS (n=42) and TP-VATS (n=155) groups, with propensity score matching applied to ensure baseline comparability.
• Clinical outcomes, including operative time, blood loss, chest drainage duration, hospital stay, and postoperative pain scores, were compared between the two groups.

Main Results:

• Both SP-VATS and TP-VATS achieved successful thymoma resection without conversion to thoracotomy or additional incisions.
• The SP-VATS group demonstrated significantly shorter chest drainage times and hospital stays compared to the TP-VATS group.
• Patients undergoing SP-VATS reported lower visual pain scores at 24 and 72 hours post-surgery, with no significant differences in operative time or intraoperative blood loss.

Conclusions:

• Single-port VATS (SP-VATS) is a safe and feasible surgical option for thymoma resection.
• SP-VATS offers advantages over multi-port VATS, including reduced postoperative pain and accelerated patient recovery.
• The findings support the wider adoption of SP-VATS as a less invasive approach for thymoma treatment.