Background: VATS thymectomy, performed using the intercostal approach
(LVATS), is the most widely used minimally invasive surgical treatment for
thymus surgery worldwide. Subxiphoid single-port thoracoscopic thymectomy
(SVATS) is a recent alternative approach to LVATS.
Methods: Between May 2019 and February 2023, 60 patients with nonthymomatous
myasthenia gravis were enrolled in this prospective study.
Patients were randomly divided into two groups: (The LVATS group and
the SVATS group); each group contained 30 patients. The mean operative
time, blood loss, conversion to open thymectomy, duration of postoperative
pleural drain, total length of hospital stay, and postoperative complications
were evaluated.
Results: The mean age was 37.3±5.61 in the LVATS group, while it was
39.7±6.39 in the SVATS group. The mean operating times were 94.66±14.31
minutes in the LVATS group and 90.56±10.80 minutes in the SVATS group,
with no significant difference observed (P=0.227). The LVATS group had
a significant drop in hemoglobin level (1.86±0.77 gm%) compared to
the SVATS group (1.31±0.46 gm%) (P=0.014). The mean duration of
chest drains was significantly longer in the LVATS group (2.03±0.18 days)
compared to the SVATS group (1.70±0.46 days)(p=0.001). The mean
duration of postoperative pain was significantly longer in the LVATS group
(8.36±0.80 days) compared to the SVATS group (6.16±1.14 days)(p=0.018).
The mean total length of hospital stay was significantly longer in the LVATS
group (12.46±0.73days) compared to the SVATS group (11.06±0.58 days)
(P=0.003).