Subxiphoid Nonintubated Thymectomy With Pericardial Resection

The authors present the case of an 80-year-old woman with a large anterior mediastinal mass compressing her right ventricle outflow tract as an incidental finding. The resection of the mass was performed through a subxiphoid uniportal approach while the patient was on spontaneous ventilation. No opioids were used. The mass, which turned out to be a stage T1bN0M0 type A thymoma, was in close contact with the pericardium so that it required resection of a pericardial area for complete excision.

The authors show how the minimally invasive subxiphoid approach, which makes pain management easier, can be combined with the "minimally invasive" nonintubated opioid-free anesthesia, which allows one to avoid the opioid side effects (nausea and vomiting, drowsiness, and ileum), and to avoid the use of muscle relaxants, which is very important in myasthenic patients.

Reference

Ali JM, Volpi S, Jiang L, Yang C, Wu L, Jiang G, et al. The future of minimally invasive thymectomy: the uniportal subxiphoid video-assisted thoracic surgery technique—a case series. J Vis Surg. 2018;4:222.

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