ORIGINAL ARTICLE   

Chirurgia 2021 February;34(1):7-13

DOI: 10.23736/S0394-9508.20.05086-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Videothoracoscopic versus open resection in the treatment of mediastinal tumors: a prospective study

Huynh Q. KHANH ¹, Vu H. VINH ¹, Nguyen V. KHOI ^{1, 2}, Nguyen L. VUONG ^{2, 3} ✉

¹ Department of Thoracic Surgery, Cho Ray Hospital, Ho Chi Minh City, Vietnam; ² Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; ³ Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam

BACKGROUND: The comparison of patients undergoing resection for mediastinal tumors in videothoracoscopic surgery (VTS) versus open surgery is still deficient. This study aimed to compare outcomes of these procedures in patients with mediastinal tumor.
METHODS: A single-center, prospective study ran from 2010 to 2013. Patients with mediastinal tumor were divided into two groups based on operative technique (VTS vs. open surgery). Outcomes were operative duration, intraoperative blood loss, chest drainage duration, postoperative hospitalization duration, pain score and complications.
RESULTS: There were 113 patients in the VTS group and 96 patients in the open group. Malignancy accounted for 31.9% and 51% of cases in the VTS and open groups, respectively. Compared to open group, VTS group had significantly shorter duration of operation (75.9±36.5 vs. 129.0±54.7 minutes), chest drainage (2.1±0.3 vs. 3.1±0.9 days), hospitalization (5.4±1.4 vs. 7.8±2.6 days), less amount of intraoperative blood loss (65.7±109.4 vs. 253.5±467.4 mL), lower postoperative pain scores (4.6±1.3 vs. 6.6±1.5), and lower complication rate (0.9% vs. 13.5%). Multivariable regression analyses confirmed the superior of VTS after adjusting for clinically relevant confounders.
CONCLUSIONS: Compared to open surgery, VTS is less traumatic and faster recovered. We advocate the VTS approach as a favored option for resection of mediastinal tumors.

KEY WORDS: Thoracic surgery, video-assisted; Thoracotomy; Sternotomy; Mediastinal neoplasms; Mediastinal cyst