COMPARISON OF SUBXIPHOID AND LATERAL INTERCOSTAL APPROACH IN ANTERIOR MEDIASTINAL PATHOLOGIES

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Akarsu I., Aslan M. T., Kurtoğlu Turan A., Ahmadova G., Sayan M., Kurul İ. C., ...Daha Fazla

33rd Meeting of the European Society of Thoracic Surgery, Budapest, Macaristan, 25 - 27 Mayıs 2025, ss.96, (Tam Metin Bildiri)

  • Yayın Türü: Bildiri / Tam Metin Bildiri
  • Basıldığı Şehir: Budapest
  • Basıldığı Ülke: Macaristan
  • Sayfa Sayıları: ss.96
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Gazi Üniversitesi Adresli: Evet

Özet

COMPARISON OF SUBXIPHOID AND LATERAL INTERCOSTAL APPROACH IN ANTERIOR MEDIASTINAL

PATHOLOGIES


Irmak Akarsu, Muhammet Tarik Aslan, Aysegul Kurtoglu Turan, Gunel Ahmadova, Muhammet

Sayan, Ismail Cuneyt Kurul, Ali Celik

Gazi University Faculty of Medicine, Thoracic Surgery, Ankara, Turkey


Background: The anterior mediastinum is the compartment where mediastinal lesions are most

frequently seen. Both subxiphoid approaches (SA) and lateral intercostal approaches (LA) are used in

anterior mediastinal lesions. In this study, we aimed to compare the outcomes and advantages of SA and

LA.

Methods: Between January 2013 and December 2024, the patients who underwent minimally invasive

surgery for anterior mediastinal lesions were retrospectively analyzed. The study's main objectives were

the characteristics of the patients, operation time, length of hospital stay (LoHS), drain type, drain

duration, postoperative complications, and Visual Analogue Scale (VAS) analysis.

Results: A total of 79 patients were included in this study. Of these, % 58.2%  (n=46) cases were operated

via LA and 41.8% (n=33) via SA. No significant difference was found in operation time, LoHS, and

complications. The most common postoperative complication was serous wound drainage. In one patient

in the LA group, hence hemothorax was seen on postoperative day 1, revision surgery had to be done.

Drain removal time was shorter in the subxiphoid group, but no statistical difference was found

(p=0.059). In patients whose drain removal time was under 2 days, the LoHS was also significantly

shorter (p<0.001). The mean VAS was 2.24±1.25 in the SA group and 4.22±1.31 in the LA group.

Conclusion: This study shows that VAS was significantly affected by SA. However, it was observed that no

superiority between SA and LA regarding operation time, LoHS, and perioperative complications.

Therefore, SA may be preferred over LA in anterior mediastinal lesions and may improve patients' quality

of life with less pain.