Chronic Neuralgia After Single-Port Versus Multiport Trans-Subxiphoid Robotic Mediastinal Surgery: A Prospective...

Area of Science:

• Minimally Invasive Surgery
• Thoracic Surgery
• Robotic Surgery

Background:

• This study is a secondary analysis of a prospective clinical trial (ClinicalTrials.gov identifier: NCT05455840).

Purpose of the Study:

• To compare postoperative pain and chronic neuralgia between single-port (SP) and multiport (MP) trans-subxiphoid robotic approaches.
• Evaluate outcomes in patients with anterior mediastinum disease.

Main Methods:

• Compared SP trans-subxiphoid robotic surgery with a historical MP cohort for anterior mediastinal disease.
• Assessed acute pain using the Numeric Rating Scale (NRS) on postoperative days 0, 1, 2, and at discharge.
• Evaluated chronic neuralgia at 6 months using the PainDetect Questionnaire (PDQ).

Main Results:

• Chronic neuralgia occurred in 6.7% of the SP group versus 38.9% of the MP group (p=0.081).
• Most neuralgia cases in the MP group involved multiple domains, while the single SP case had only one symptom.

Conclusions:

• Single-port (SP) trans-subxiphoid robotic surgery offers comparable perioperative pain.
• SP robotic surgery is associated with a significantly lower risk of developing chronic neuralgia.