探讨非插管单孔胸腔镜(non-intubated uniportal video-assisted thoracic surgery，NI UVATS)经剑突纵隔肿瘤切除术的可行性，并归纳其手术技巧及临床疗效。

回顾性分析2019年3月至2023年7月期间，由上海肺科医院胸外科同一手术团队实施的20例NI UVATS经剑突纵隔肿瘤切除患者的临床资料，其中包括胸腺囊肿11例、胸腺瘤7例、胸腺癌1例以及淋巴源增生1例。

20例手术均顺利实现根治性切除，无一例需中转开胸。平均手术时间为66.00±26.83 min。术后当日引流量平均值为265(115，435)ml，患者术后平均住院时间为2.85±1.27 d。在7例胸腺瘤患者中，1例接受了术后放疗，术后3年随访未见转移或复发；另1例胸腺癌患者则接受了术后化疗与放疗，同样在3年随访期内未出现转移复发。术后平均随访时间为28.5±10.7个月，期间无一例死亡。

在经验丰富的单孔胸腔镜外科医师与麻醉医师紧密配合下，对经过严格筛选的病例施行NI UVATS经剑突纵隔肿瘤切除术，具有明确的临床可行性。

To explore the feasibility of non-intubated uniportal video-assisted thoracic surgery (NI UVATS) for the resection of mediastinal tumors via a subxiphoid approach, and to summarize the surgical techniques and clinical outcomes.

A retrospective analysis was conducted on the medical records of 20 patients who underwent NI UVATS for subxiphoid resection of mediastinal tumors by the same surgical team in the Department of Thoracic Surgery at Shanghai Pulmonary Hospital between Mar. 2019 and Jul. 2023. The pathological diagnoses included 11 cases of thymic cyst, 7 cases of thymoma, 1 case of thymic carcinoma, and 1 case of lymphoid hyperplasia.

All 20 procedures were successfully completed with radical resection, and no cases required conversion to open thoracotomy. The mean operative time was 66.00 ± 26.83 minutes. The mean drainage volume on the day of surgery was 265 (115, 435) ml, and the mean postoperative hospital stay was 2.85 ± 1.27 days. Among the 7 patients diagnosed with thymoma, one received postoperative radiotherapy and showed no metastasis or recurrence at the 3-year follow-up. The one patient diagnosed with thymic carcinoma received postoperative chemotherapy and radiotherapy, with no metastasis or recurrence observed at the 3-year follow-up. The mean postoperative follow-up duration was 28.5 ± 10.7 months, with a mortality rate of 0% during this period.

For carefully selected patients, NI UVATS for subxiphoid resection of mediastinal tumors is feasible when performed by an experienced uniportal VATS surgeon in close collaboration with an anesthesiologist.