ObjectiveTo introduce an innovative technique, the "balance-shaped sternal elevation device" and its application in the subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) for anterior mediastinal masses resection. MethodsPatients who underwent single-port thoracoscopic assisted anterior mediastinal tumor resection through the xiphoid process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from May to June 2024 were included, and their clinical data were analyzed. ResultsA total of 7 patients were included, with 3 males and 4 females, aged 28-72 years. The diameter of the tumor was 1.9-17.0 cm. The operation time was 62-308 min, intraoperative blood loss was 5-100 mL, postoperative chest drainage tube retention time was 0-9 days, pain score on the 7th day after surgery was 0-2 points, and postoperative hospital stay was 3-12 days. All patients underwent successful and complete resection of the masses and thymus, with favorable postoperative recovery. ConclusionThe "balance-shaped sternal elevation device" effectively expands the retrosternal space, providing surgeons with satisfactory surgical views and operating space. This technique significantly enhances the efficacy and safety of minimally invasive surgery for anterior mediastinal masses, reduces trauma and postoperative pain, and accelerates patient recovery, demonstrating important clinical significance and application value.
[Abstract]With the adoption of the surgical principles emphasizing minimally invasive, precise, and individualized procedures, the subxiphoid video-assisted thoracoscopic surgery with sternal elevation has become a pivotal approach for resecting anterior mediastinal masses. This approach significantly enhances surgical exposure, minimizes operative trauma, alleviates postoperative pain, and improves cosmetic outcomes. To establish a standardized framework and regulate the application of this approach, this consensus integrates practical experience from thoracic surgery centers in China alongside evidence from the literature. The core issues addressed in this consensus include surgical indications, preoperative assessment, anesthesia and intraoperative coordination, critical surgical techniques, postoperative management, complication prevention and treatment, as well as training and quality control systems. This consensus aims to provide a safer and more effective minimally invasive technique for patients with anterior mediastinal masses and to advance the innovation in minimally invasive anterior mediastinal surgery.