Recently, the original research results of thoracoscopic mediastinal surgery for subxiphoid thymectomy were twice published on Annals of Thoracic Surgery, a top international journal of thoracic and Cardiac surgery, and the research was carried out by director of National Center for Respiratory Medicine, the First Affiliate Hospital of GUANGZHOU Medical University, deputy director of National Clinical Research Center for Respiratory Disease, Head of Guangzhou Institute of Respiratory Health, and leader in the field of thoracic surgery, Professor He Jianxing’s team.

Corresponding authors: He Jianxing; First authors: Jiang Long, Chen Hanzhang

Thymoma is one of the most common mediastinal tumors, which is derived from different thymic epithelial cells and has unique clinicopathological characteristics, accompanied by diseases with multiple paraneoplastic syndromes.

The treatment for early-stage thymoma is mainly surgery. Due to special location, an open surgery with a median sternum incision was adopted in the early stage. Although the intraoperative vision in an open surgery is good, the trauma is great, the pain is obvious, the recovery time is long, and there are many postoperative complications.

With the progress of minimally invasive thoracic surgery, thoracoscopic sided mediastinal surgery is less traumatic, but it tends to cause muscle and intercostal nerve damage, obvious postoperative pain, and movement and sensory disorders. What’s worse, doctors’ intraoperative vision is greatly obstructed, which is likely to cause partial thymus resection, affecting the effect of the treatment.

In order to increase the effect of the minimally invasive thoracic surgery, in recent years, Professor He Jianxing’s team has never stopped to explore and study the treatment for anterior mediastinal masses through thoracoscopic surgery for subxiphoid thymectomy, which has achieved pretty good results. Compared to the same minimally invasive thoracoscopic contralateral approach, there were no significant differences in the bleeding, chest tube drainage, postoperative complications, and postoperative hospital stay in the new surgery, but the postoperative pain was significantly reduced, the postoperative recovery was accelerated, and the effect was significant. Besides, the subxiphoid approach keeps the advantages of thoracotomy with a median sternum incision. Compared with the thoracoscopic contralateral approach, it has a good intraoperative vision with better effects.

Based on the above introduction to thymectomy, compared to median thymectomy and thoracoscopic contralateral approach, the subxiphoid approach has the following advantages:

1.Good intraoperative vision, which is conducive to the surgery

2.Small trauma and minor wound

3.Mild postoperative pain and few postoperative complications, which can accelerate recovery.

As a result, thoracoscopic surgery for subxiphoid thymectomy is a safe and effective treatment, which can not only minimize the original anterior mediastinal tumor resection with small incision and small trauma, but can also greatly reduce the postoperative pain and accelerate recovery. Professor He Jianxing’s team published a series of research results on thoracoscopic surgery for subxiphoid thymectomy, which is precisely the effort and breakthrough made for traditional methods of surgery.