经侧胸入路与经剑突下入路胸腔镜手术治疗纵隔肿瘤的应用效果研究

doi:10.3969/j.issn.1006-6233.2025.05.019

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Abstract Objective: To study the efficacy of thoracoscopic surgery via lateral thoracic approach and subxiphoid approach in the treatment of mediastinal tumor (MT) and its influence on the levels of plasma pain-causing factors. Methods: Totally 118 patients with MT in the hospital from June 2020 to June 2023 were selected, and were divided into lateral thoracic group (thoracoscopic surgery via lateral thoracic approach, n=46) and xiphoid group (thoracoscopic surgery via subxiphoid approach, n=72) according to the surgical approaches. The propensity score method was used for 1∶1 matching, and 43 cases were included in each group. The surgical indicators, postoperative pain, pain-causing factors, incidence rates of postoperative complications, recurrence rate and survival status at 1 year after surgery were compared between groups. Results: The extubation time and analgesic days in xiphoid process group were shorter than those in lateral chest group, the differences were statistically significant (P<0.05). The scores of numerical rating scale (NRS) at T1, T2 and T3 in the xiphoid group with (3.53±0.86) points, (2.46±0.65) points and (1.67±0.41) points were lower than (4.26±1.18) points, (3.73±0.92) points and (2.18±0.54) points in the lateral thoracic group (P<0.05). Serum bradykinin (BK), neuropeptide Y (NPY) and prostaglandin E2 (PGE2) in the xiphoid group at T1, T2 and T3 were lower compared with those in the lateral thoracic group (P<0.05). There was no significant difference in total complications between xiphoid process group (6.99%) and lateral chest group (13.98%) (P>0.05). There was no significant difference in postoperative recurrence rate (2.33% vs 2.33%) and fatality rate (0% vs 2.33%) between the two groups (P>0.05). Conclusion: Thoracoscopic surgery via subxiphoid approach for patients with MT can effectively shorten the postoperative extubation time and analgesic use time, and reduce the levels of postoperative pain-causing factors, and it has high treatment safety.

Key words： Lateral thoracic approach Subxiphoid approach Thoracoscopic surgery Mediastinal tumor

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	SUN Jian
	GAO Congrong
	PEI Shaohua

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SUN Jian,GAO Congrong,PEI Shaohua. Study on the Efficacy of Thoracoscopic Surgery for Mediastinal Tumors by Lateral Thoracic Approach and Subxiphoid Approach[J]. HeBei Med, 2025, 31(5): 811-816.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.05.019 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I5/811

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