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.
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