{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:40:20Z","timestamp":1792813220169,"version":"4.5.0"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":292,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tumor proximity to the left brachiocephalic vein (LBCV) may affect vascular exposure and dissection during the subxiphoid approach (SXA). We investigated the association between tumor\u2013LBCV distance and operative time in patients undergoing subxiphoid robot\u2010assisted or video\u2010assisted thoracoscopic surgery for thymoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive patients who underwent minimally invasive SXA for thymoma between 2019 and 2024 were retrospectively reviewed. The shortest tumor\u2013LBCV distance (d\u2010LBCV) was measured on preoperative computed tomography. Associations of d\u2010LBCV and tumor size with operative time were evaluated using correlation, interaction, and multivariable linear regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 64 patients with clinical Stage I thymoma without radiological evidence of vascular invasion, 45 and 19 underwent robot\u2010 and video\u2010assisted thoracoscopic surgery, respectively. Overall, shorter d\u2010LBCV (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.357,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0037) and larger tumor size (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.328,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0082) were correlated with longer operative time. In multivariable analysis adjusting for tumor size, surgical platform, and surgical procedure, shorter d\u2010LBCV remained significantly associated with longer operative time (regression coefficient, \u22127.62\u2009min per 10\u2010mm increase; 95% CI, \u221213.21 to \u22122.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). Surgical procedure was also significantly associated with operative time, whereas tumor size and surgical platform were not. Although platform\u2010specific analyses showed different association patterns, interaction analyses showed no significant differences between RATS and VATS for tumor size or d\u2010LBCV.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Shorter d\u2010LBCV was independently associated with longer operative time during minimally invasive SXA for thymoma, despite adjustment for tumor size, surgical platform, and surgical procedure. d\u2010LBCV may provide useful anatomical information for preoperative planning; although further validation is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70390","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:39:00Z","timestamp":1792543140000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations Between Tumor\u2013Left Brachiocephalic Vein Distance and Operative Time in Minimally Invasive Subxiphoid Surgery for Thymoma"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4504-232X","authenticated-orcid":false,"given":"Toru","family":"Kimura","sequence":"first","affiliation":[{"name":"Department of General Thoracic Surgery The University of Osaka Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8959-3823","authenticated-orcid":false,"given":"Yudai","family":"Miyashita","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery The University of Osaka Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9928-7245","authenticated-orcid":false,"given":"Hideki","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery The University of Osaka Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery The University of Osaka Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kanou","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery The University of Osaka Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3509-9536","authenticated-orcid":false,"given":"Naoko","family":"Ose","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery The University of Osaka Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2540-5288","authenticated-orcid":false,"given":"Yasushi","family":"Shintani","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery The University of Osaka Graduate School of Medicine  Suita 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