Feasibility of twenty-four-hour discharge of patients with anterior mediastinal tumors after subxiphoid video-assisted thoracoscopic surgery (VATS) procedure

Background: A wide variety of surgical procedures are administrated in day-surgery unit and are able to be discharged within 24 hours with high efficiency, safety and economy. This study sought to evaluate the safety and feasibility of 24-hour discharge of patients with anterior mediastinal tumors after subxiphoid video- assisted thoracoscopic surgery (VATS) and describe our surgery procedure experiences. Methods: A total of 70 selected patients with anterior mediastinal tumors undergoing subxiphoid VATS were included in this prospective study. The patients' clinical features, intraoperative and postoperative complications were assessed, and postoperative pain scale and satisfaction scores were also evaluated. Results: The subxiphoid VATS was completed with no conversion to open surgery in all included patients and were all discharged within 24 hours after surgery. The mean operative time +/- standard deviation (SD) was 70.50 +/- 18.98 min, and the mean operative blood loss volume +/- SD was 45.50 +/- 15.25 mL. In addition, 80% of the patients reported a postoperative pain scale score less than 3 by the day before discharge, and all patients expressed satisfaction with receiving VATS in the day-surgery unit at 2 weeks after discharge. Conclusions: The use of subxiphoid VATS is a safe, efficient and feasible surgical approach for patients with anterior mediastinal tumors discharged within 24 hours.