Robotic Mediastinal Tumor Resections: Position and Port Placement
Abstract
:1. Introduction
2. Anterior Mediastinal Tumor
2.1. Total and Extended Thymectomy
2.2. Lateral Versus Subxiphoid Approach
2.3. Partial Thymectomy
3. Posterior Mediastinal Tumor
3.1. Posterior Tumor Resection
3.2. Dumbbell Tumor Resection
4. Superior Mediastinal Tumor
5. Middle Mediastinal Tumor
6. Literature Summary and Preferred Position and Approach for RATS Mediastinal Tumor Resection
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Lateral | Subxiphoid | p-Value | |
---|---|---|---|
(n = 13) | (n = 16) | ||
Patient characteristics | |||
Age (years old) | 61.9 ± 14.8 | 59.1 ± 13.7 | 0.6023 |
Gender (male/female) | 5/8 | 8/8 | 0.5344 |
Tumor size | 3.1 ± 1.9 | 3.5 ± 1.9 | 0.6623 |
Procedure | 0.0788 | ||
Extended thymectomy | 2 | 7 | |
Total thymectomy | 11 | 9 | |
Perioperative outcomes | |||
Operative time (min) | 180.4 ± 61.6 | 185.6 ± 49.5 | 0.8011 |
Console time (min) | 123.2 ± 60.0 | 110.8 ± 44.6 | 0.5280 |
Operative time–Console time (min) | 57.2 ± 8.9 | 74.8 ± 10.5 | <0.0001 |
Intraoperative bleeding (mL) | 21.9 ± 23.6 | 14.4 ± 17.5 | 0.3312 |
Intraoperative complications | 0 (0%) | 0 (0%) | - |
Postoperative complications | 1 (7.7%) | 0 (0%) | 0.2589 |
Maximum size of incision (cm) | 2.3 ± 0.6 | 3.0 ± 0.0 | 0.0001 |
WBC POD5 (×103/mm3) | 5.72 ± 1.01 | 6.19 ± 1.98 | 0.4555 |
CRP POD5 (mg/dL) | 2.25 ± 2.03 | 3.59 ± 1.92 | 0.0799 |
NRS POD5 | 1.0 ± 0.6 | 0.8 ± 1.0 | 0.5157 |
Tumor Location | Author | Country | Year | Total | MG | Thymoma | Approach | Position | Ports | Conversion (%) |
---|---|---|---|---|---|---|---|---|---|---|
Anterior | Rückert | Germany | 2008 | 106 | 95 | 12 | Left | Semi-supine | 3 | 1.1 |
Anterior | Freeman | USA | 2011 | 75 | 75 | 0 | Left | Supine | 3 | 1.1 |
Anterior | Schneiter | Switzerland | 2013 | 58 | 25 | 20 | Left | Semi-supine | 3 | 0.0 |
Anterior | Marulli | Italy | 2013 | 79 | 45 | 79 | Left | Semi-supine | 3 | 1.3 |
Anterior | Jun | China | 2014 | 55 | n.a. | 21 | Right (>Left) | Supine | 4 | 0.0 |
Anterior | Qian | China | 2017 | 51 | 4 | 51 | Right (>Left) | Semi-supine | 4 | 0.0 |
Anterior | Kang | Korea | 2020 | 110 | 18 | 67 | Subxiphoid | Supine | 3 | 0.9 |
Anterior | Li | China | 2020 | 60 | 4 | 55 | Right | Supine | 3 | n.a. |
Anterior | Azenha | Switzerland | 2021 | 81 | n.a. | 34 | Left (>Right) | n.a. | 3 | 0.0 |
Anterior | Marcuse | Netherlands | 2021 | 130 | 89 | 130 | Right (>Left) | Supine | 3 | 7.7 |
Anterior | Romano | Italy | 2021 | 53 | 34 | 53 | Left (>Right) | Supine | 3 | 1.9 |
Anterior | Wilshire | USA | 2021 | 123 | 26 | 123 | Left (>Right) | Semi-supine | 3 | n.a. |
Anterior | Kang | Korea | 2021 | 158 | 27 | 132 | Subxiphiod/Left/Right | Supine | 3 | 1.3 |
Anterior | Kumar | India | 2021 | 111 | 68 | 111 | Left/Right | Supine | 3 | 6.3 |
Anterior | Geraci | USA | 2021 | 84 | n.a. | 84 | Right (>Left) | Semi-supine | 3 | 2.3 |
Anterior | Zhang | China | 2022 | 87 | 87 | 53 | Subxiphoid | Supine | 4 | 0.0 |
Anterior | Bongiolatti | Italy | 2022 | 54 | 13 | 54 | Left (>Right) | Semi-supine | 3 | 11.1 |
Anterior | Park | Korea | 2022 | 389 | 44 | 198 | Subxiphiod/Left (>Right) | Supine | 3 | 0.5 |
Superior | Wang | China | 2021 | 15 | - | - | Lateral | Lateral decubitus | 3 | 0.0 |
Posterior | Cerfolio | USA | 2012 | 75 | - | - | Lateral | Lateral decubitus | 4 | 1.3 |
Posterior | Li | China | 2020 | 58 | - | - | Lateral | Lateral decubitus | 3 | 3.4 |
Tumor Location | Procedure | Preferred Position | Preferred Approach |
---|---|---|---|
Anterior mediastinum | Extended thymectomy | Supine | Subxiphoid |
Total thymectomy | Supine | Subxiphoid or lateral | |
Partial thymectomy | Supine | Lateral | |
Superior mediastinum | Tumor resection | Lateral decubitus | Lateral |
Middle mediastinum | Tumor resection | Lateral decubitus | Lateral |
Posterior mediastinum | Tumor resection | Lateral decubitus | Lateral |
Dumbbell tumor resection | Prone | Lateral |
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Okazaki, M.; Shien, K.; Suzawa, K.; Sugimoto, S.; Toyooka, S. Robotic Mediastinal Tumor Resections: Position and Port Placement. J. Pers. Med. 2022, 12, 1195. https://doi.org/10.3390/jpm12081195
Okazaki M, Shien K, Suzawa K, Sugimoto S, Toyooka S. Robotic Mediastinal Tumor Resections: Position and Port Placement. Journal of Personalized Medicine. 2022; 12(8):1195. https://doi.org/10.3390/jpm12081195
Chicago/Turabian StyleOkazaki, Mikio, Kazuhiko Shien, Ken Suzawa, Seiichiro Sugimoto, and Shinichi Toyooka. 2022. "Robotic Mediastinal Tumor Resections: Position and Port Placement" Journal of Personalized Medicine 12, no. 8: 1195. https://doi.org/10.3390/jpm12081195