Abstract

Objectives: To evaluate the advantages and limits of endoscopic thymectomy combined subxiphoid approach.

Methods: This is a prospective case series study of endoscopic thymectomy using subxiphoid incision at Thoracovascular department, University medical center, Ho Chi Minh City.

Results: There were 33 cases of endoscopic thymectomy combined subxiphoid incision at University medical center from January 2021 to April 2023. Female is predominant (68%), majority is diagnosed stable myasthenia gravis adding thymoma or thymus. Thymoma is accounted for 42,4%, the mean size of tumor is is 4 ± 1,7cm, the mean operation time 149 ± 34 phút. Complication during and after surgery, there was 1 case of right diaphragmatic perforation (accounting for 3,1%), we had to do thoracotomy for diaphragmatic restoration; 1case of postoperative respiratory failure (accounting for 3,1%), patient was ventilated by high - flow nasal cannula for 5 days. Respiratory condition was improved, patient was discharged 3 days later.

Conclusion: Endoscopic thymectomy combined with subxiphoid incision is a new approach in non - tumor myasthenia gravis as well as thymoma, providing good vision in the anterior mediastinum, important for clearly seeing the bilateral diaphragmatic nerve, creating qood condition for extended thymectomy, increasing the effectiveness of surgical treatment in myasthenia gravis as well as achieving a wide resection in thymoma.