ABSTRACT
Background: Thymectomy has been identified as Constructive and active strategy for patients with Myasthenia gravis and thymic masses which have been done classically by Open Sternotomy technique and nowadays new Minimally invasive approaches have also been introduced. In this paper , Subxiphoid Uniportal VATS(Video Assis Method : ted Thoracoscopic Surgery) Thymectomy through a single port technique by utilizing the Subxiphoid approach has been discussed. I have improvised my technique pertaining to the requirements and better recovery and better post operative outcome of the patient .This procedure is indicated for all anterior mediastinal masses and maybe extended to lung cancer.The patient was placed in supine position instead of classical lithotomy position .Carbon dioxide insufflation was not used which led to faster recovery after the surgery.After dissection and resection of thymus Bilateral pleural drain were placed which was removed usually on Post Operative day 4 or 5 and patients were discharged afterwards. Several benefits of this Results: approach were observed and documented including reduced postoperative pain, Early extubation, better post operative outcome, and better dissection . In the near future ,the Subxiphoid approach has the potential to become Conclusion: GOLD STANDARD for Thymectomy and various other conditions
ABSTRACT
BACKGROUND: Since video-assisted thoracoscopic surgery (VATS) was introduced as a new treatment modality for empyema thoracis, numerous reports have suggested that VATS is a more effective treatment method than the traditional methods that mainly use antibiotics and drainage apparatus. However, no confirmative evidence of the superiority of VATS over the traditional method has been provided yet. METHODS: We attempted to evaluate the efficacy of VATS for the treatment of empyema thoracis by reviewing past medical records and simple chest films. First, we divided the patients into two groups based on the treatment method: group A of 15 patients who were treated with the traditional method between January 2001 and December 2003, and group B of 9 patients who were treated with VATS between December 2003 and August 2006. The final outcomes used in this study were the number of days of hospital stay, chest tube duration, leukocytosis duration, febrile duration, and intravenous antibiotics usage duration. In addition, radiological improvements were compared. RESULTS: The mean age(+/-standard deviation) of 11 men and 4 women in group A was 58.2+/-15.7 years, and of 9 men and 2 women in group B was 51.6+/-9.5 years. Group B had a significantly shorter hospital stay (16.6+/-7.4 vs. 33.7+/-22.6 days; p=0.014), shorter chest tube duration (10.5+/-5.7 vs. 19.5+/-14.4 days; p=0.039), shorter leukocytosis duration (6.7+/-6.5 vs. 18.8+/-13.2 days; p=0.008), shorter febrile duration (0.8+/-1.8 vs. 9.4+/-9.2 days; p=0.004), and shorter duration of intravenous antibiotics usage (14.9+/-6.4 vs. 25.4+/-13.9 days; p=0.018). However, radiological improvements did not show any statistical differences. CONCLUSION: Early application of VATS for empyema thoracis treatment reduced hospital stay, thoracostomy tube duration, leukocytosis duration, febrile duration, and antibiotics usage duration in comparison with the traditional methods. The early performing of VATS might be an effective treatment modality for empyema thoracis.