Modified Subxiphoid Uniportal Approach in the Surgical Management of Anterior Mediastinal Tumors

Corresponding author: Guo Hong, guohong7666@163.com

DOI: 10.12201/bmr.202601.00016

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  Abstract: 【Abstract】: Objective: This study aimed to evaluate the clinical application value of the modified subxiphoid uniportal approach in the resection of anterior mediastinal tumors. Traditionally, anterior mediastinal tumors have been treated using multiportal thoracoscopic approaches, with a gradual transition toward the uniportal subxiphoid approach in recent years. Methods: A retrospective analysis was conducted on 68 patients with anterior mediastinal tumors admitted to the Department of Thoracic Surgery at the Affiliated Hospital of Yangzhou University between January 2023 and September 2025. These patients were divided into an experimental group (modified subxiphoid uniportal approach, n = 19) and a control group (three-port subxiphoid approach, n = 19) based on propensity score matching. Perioperative parameters were compared between the two groups, including operative time, intraoperative blood loss, postoperative mean drainage volume, duration of drainage tube placement, hospital stay, incision length, visual analogue scale (VAS) pain score, white blood cell count on postoperative day 1, neutrophil percentage on postoperative day 1, and postoperative complications. Results: All patients recovered uneventfully postoperatively. There were no statistically significant differences in operative time, VAS pain score, drainage tube duration, hospital stay, white blood cell count, neutrophil percentage on postoperative day 1, or postoperative complications between the two groups. However, significant differences were observed in incision length and intraoperative blood loss (P < 0.05). Firths logistic regression analysis indicated no preoperative factors influencing intraoperative blood loss. Conclusion: The modified subxiphoid uniportal approach reduces instrument interference during surgery and facilitates smoother operative maneuvers, indicating clinical value for broader adoption.

  Key words: Subxiphoid single-port; Anterior mediastinal tumor; Video-assisted thoracic surgery; clinical promotion; Propensity score matching.

  Submit time: 6 January 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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