Comparison of uniportal and three-portal video-assisted thoracoscopic thymectomy for thymoma: a propensity...

Minimally invasive thymectomy (MIT) is a surgical approach to thymectomy. To investigate the efficacy of the MIT, a retrospective comparison for perioperative outcomes of patients was conducted between uniportal and three-portal video-assisted thoracoscopic surgery (UP-VATS and TP-VATS) thymectomy.

A detailed database search identified 135 patients treated with UP-VATS thymectomy technique and 228 patients treated via TP-VATS thymectomy technique between January 2013 and December 2022 from the same surgeon and medical team. Propensity score-matched analysis was used to compare the perioperative outcomes between the two groups.

The first 20 patients were excluded to account for the learning curve effect in both groups. There were 115 patients screened in each group after propensity match. There was 14.8% morbidity in the UP-VATS group and 12.2% morbidity in the TP-VATS group, with no significant differences between the two groups. Furthermore, no significant differences in other perioperative outcomes were found between the two groups. Although the volume of drainage (86.2 vs. 76.1 mL, P=0.07) was similar between the two groups, the operative time in the UP-VATS group (117.2 vs. 96.7 min, P<0.001) was longer than that in the TP-VATS group.

Thymectomy treatment of TP-VATS is an advisable procedure for patients with thymoma, while these two MIT techniques are both appropriate for thymoma treatment.