{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:18:28Z","timestamp":1787008708244,"version":"build-2736575974"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2020,7,4]],"date-time":"2020-07-04T00:00:00Z","timestamp":1593820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p\/>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>The aim of the present study was to examine some initial results and learning curves concerning subxiphoid single-port thymectomy (SSPT), thereby clarifying the safety of this surgical approach and describing the precautions for adopting it.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>From March 2011 to August 2019, a total of 203 patients underwent thymectomy for either anterior mediastinal tumours or myasthenia gravis at Fujita Health University Hospital. Of these 203 patients, 147 patients who had undergone SSPT were selected as participants for the present study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of the 147 cases, transition to a different approach was required in three (2.0%) cases: two (1.3%) cases transitioned to median sternotomy, whereas one (0.7%) case transitioned to the side chest trans-intercostal approach. The two cases that transitioned to median sternotomy were the second cases for different operators after they began performing this technique. There were six (4.0%) cases with complications and no deaths. The operation time cumulative summation learning curve analysis revealed that the curves descended from the 38th case. In the 83 cases handled by one surgeon, the learning curves descended from the 31st case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>SSPT is a safe modality with few complications and no associated cases of mortality reported. Operators are required to experience 31\u201338 cases until the operation time for SSPT was stabilized. Special care should be exercised to prevent vascular damage in the vicinity of the innominate veins during the early stages after SSPT introduction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa183","type":"journal-article","created":{"date-parts":[[2020,5,2]],"date-time":"2020-05-02T07:08:27Z","timestamp":1588403307000},"page":"i44-i49","source":"Crossref","is-referenced-by-count":12,"title":["Early outcomes in 147 consecutive cases of subxiphoid single-port thymectomy and evaluation of learning curves"],"prefix":"10.1093","volume":"58","author":[{"given":"Takashi","family":"Suda","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisato","family":"Ishizawa","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Nagano","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9415-9711","authenticated-orcid":false,"given":"Takahiro","family":"Negi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Tochii","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Tochii","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Hoshikawa","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,4]]},"reference":[{"key":"2020081312171832400_ezaa183-B1","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/S0003-4975(10)62457-5","article-title":"An improved technique to facilitate transcervical thymectomy for myasthenia gravis","volume":"45","author":"Cooper","year":"1988","journal-title":"Ann Thorac Surg"},{"key":"2020081312171832400_ezaa183-B2","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/0003-4975(92)91162-3","article-title":"Thoracoscopic resection of an anterior mediastinal tumor","volume":"54","author":"Landreneau","year":"1992","journal-title":"Ann Thorac Surg"},{"key":"2020081312171832400_ezaa183-B3","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1016\/S0140-6736(06)68700-X","article-title":"Persistent postsurgical pain: risk factors and prevention","volume":"367","author":"Kehlet","year":"2006","journal-title":"Lancet"},{"key":"2020081312171832400_ezaa183-B4","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.athoracsur.2011.08.047","article-title":"Single-port thymectomy through an infrasternal approach","volume":"93","author":"Suda","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2020081312171832400_ezaa183-B5","first-page":"i54","article-title":"Video assisted thoracoscopic thymectomy versus subxiphoid single-port thymectomy: initial results","volume":"49","author":"Suda","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"2020081312171832400_ezaa183-B6","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1007\/s11748-013-0337-y","article-title":"Dual-port thymectomy using subxiphoid approach","volume":"62","author":"Suda","year":"2014","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"2020081312171832400_ezaa183-B7","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1093\/icvts\/ivv001","article-title":"Trans-subxiphoid robotic thymectomy","volume":"20","author":"Suda","year":"2015","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2020081312171832400_ezaa183-B8","doi-asserted-by":"crossref","first-page":"2485","DOI":"10.1002\/1097-0142(19811201)48:11<2485::AID-CNCR2820481123>3.0.CO;2-R","article-title":"Follow-up study of thymomas with special reference to their clinical stages","volume":"48","author":"Masaoka","year":"1981","journal-title":"Cancer"},{"key":"2020081312171832400_ezaa183-B9","doi-asserted-by":"crossref","first-page":"5100","DOI":"10.21037\/jtd.2018.08.87","article-title":"Learning curve for uniportal video-assisted thoracoscopic surgery lobectomy-results from 120 consecutive patients","volume":"10","author":"Liu","year":"2018","journal-title":"J Thorac Dis"},{"key":"2020081312171832400_ezaa183-B10","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/S0140-6736(74)92345-9","article-title":"Why don\u2019t doctors use CUSUMs?","volume":"1","author":"Chaput de Saintonge","year":"1974","journal-title":"Lancet"},{"key":"2020081312171832400_ezaa183-B11","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1097\/01.sla.0000167857.14690.68","article-title":"Analysis of the surgical learning curve using the cumulative sum (CUSUM) method","volume":"242","author":"Tekkis","year":"2005","journal-title":"Ann Surg"},{"key":"2020081312171832400_ezaa183-B12","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/j.athoracsur.2012.04.097","article-title":"Minimally invasive thymectomy and open thymectomy: outcome analysis of 263 patients","volume":"94","author":"Jurado","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2020081312171832400_ezaa183-B13","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/j.athoracsur.2017.03.054","article-title":"Video-assisted thoracic surgery thymectomy versus sternotomy thymectomy in patients with thymoma","volume":"104","author":"Agatsuma","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2020081312171832400_ezaa183-B14","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.ejcts.2007.12.056","article-title":"Learning curve in videothoracoscopic thymectomy: how many operations and in which situations?","volume":"34","author":"Toker","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"2020081312171832400_ezaa183-B15","doi-asserted-by":"crossref","first-page":"3880","DOI":"10.1007\/s00464-019-07035-y","article-title":"Defining the learning curve of robotic thoracic surgery: what does it take?","volume":"33","author":"Power","year":"2019","journal-title":"Surg Endosc"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/58\/Supplement_1\/i44\/33649671\/ezaa183.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/58\/Supplement_1\/i44\/33649671\/ezaa183.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T00:48:58Z","timestamp":1597366138000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/58\/Supplement_1\/i44\/5867266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,4]]},"references-count":15,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2020,7,4]]},"published-print":{"date-parts":[[2020,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezaa183","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,8]]},"published":{"date-parts":[[2020,7,4]]}}}