改良剑突下单孔入路在前纵隔肿瘤切除术中的应用OA

Objective This study aimed to evaluate the clinical application value of the modified subxiphoid uniportal approach in the resection of anterior mediastinal tumors.Traditionally,anterior mediastinal tumors have been treated using multiportal thoracoscopic approaches,with a gradual transition toward the uniportal subxiphoid approach in recent years.Methods A retrospective analysis was conducted on 68 patients with anterior mediastinal tumors admitted to the Department of Thoracic Surgery at the Affiliated Hospital of Yangzhou University between January 2023 and September 2025.These patients were divided into experimental group(modified subxiphoid uniportal approach,n=19)and control group(three-port subxiphoid approach,n=19)based on propensity score matching.Perioperative parameters were compared between two groups,including operative time,intraoperative blood loss,postoperative mean drainage volume,duration of drainage tube placement,hospital stay,incision length,visual analogue scale(VAS)pain score,white blood cell count on postoperative day 1,neutrophil percentage on postoperative day 1,and postoperative complications.Results All patients recovered uneventfully postoperatively.There were no statistically significant differences in operative time,VAS pain score,drainage tube duration,hospital stay,white blood cell count,neutrophil percentage on postoperative day 1,or postoperative complications between two groups.However,significant differences were observed in incision length and intraoperative blood loss(P<0.05).Firth's Logistic regression analysis indicated no preoperative factors influencing intraoperative blood loss.Conclusion The modified subxiphoid uniportal approach reduces instrument interference during surgery and facilitates smoother operative maneuvers,indicating clinical value for broader adoption.