ABSTRACT
Objective To explore the clinical value of single utility port video-assisted thoracoscopic surgery ( VATS ) for mediastinal tumor . Methods A retrospective analysis was performed on clinical data of 55 patients with mediastinal tumor who received surgical treatment with single utility port video-assisted thoracoscopic surgery in this department from December 2013 to June 2016.Routinely, the surgery was conducted by intraoperatively inserting the thoracoscope via an incision at the seventh intercostals space on the midaxillary line as the observation hole , and making a 3-4 cm transverse incision at the fourth intercostals space between the midaxillary line and the anterior axillary line as the operation hole .Postoperatively , the observation hole served as the passage for closed thoracic drainage tube . Results Among the 55 patients, 50 received total thoracoscopic surgery .In 3 cases with relatively large tumor, the surgery was conducted with additional assisted small incisions .Thoracotomy was carried out in another 2 cases due to bleeding when separating pulmonary artery branch and difficult hemostasis under thoracoscopy .The surgery duration was (100 ±46) min, the intraoperative blood loss was (85 ±38) ml, the postoperative chest drainage volume was (450 ±80) ml, the postoperative time to chest tube withdrawal was (3.0 ±1.6) d, and the postoperative duration of hospital stay was (6.2 ±1.5) d in the 50 cases of VATS.All the patients recovered well .Postoperatively , there were 1 case of myasthenic crisis , 2 cases of pneumothorax and 3 cases of pleural effusion, all of which were improved with symptomatic treatment .All the 55 cases were followed up for 2-24 months (mean, 11.2 ±7.3 months) and there were no tumor recurrences . Conclusion Single utility port VATS of mediastinal tumor resection has advantages in safety , efficacy, and cosmetic outcomes , being worthy of further clinical application .