Application and efficacy evaluation of thoracoscopic techniques in ventricular tumors resection

Background: Although fully thoracoscopic resection of atrial tumors has become well established, evidence supporting non-robotic fully thoracoscopic ventricular tumor resection remains limited, largely owing to the deep anatomical location of ventricular lesions, restricted operative space, and the complexity of subvalvular structures. Methods: We conducted a retrospective analysis of eight patients who underwent right-sided three-port fully thoracoscopic ventricular tumor resection between August 2022 and July 2025. Perioperative outcomes and near-term follow-up results were systematically evaluated. Results: All patients successfully underwent thoracoscopic tumor resection; one patient concurrently received tricuspid valve repair involving papillary muscle reattachment. Intraoperative transoesophageal echocardiography confirmed complete tumor excision in all cases. No major postoperative complications, including mortality or embolic events, were observed. The cardiopulmonary bypass time was (107 ± 64) min, and the aortic cross-clamp time was (49 ± 39) min. The mean intensive care unit stay was (21.5 ± 4.1) h, mechanical ventilation time was (16.4 ± 2.5) h, and postoperative hospital stay was (5 ± 1) days. No patient required postoperative allogeneic blood transfusion. Echocardiography before discharge and during follow-up demonstrated no residual tumors or significant valvular regurgitation. The mean follow-up duration was (21 ± 12) months, during which no tumor recurrence or distant metastasis was detected. Conclusion: A right-sided three-port fully thoracoscopic approach allows safe and controlled complete resection of ventricular tumors, with favourable perioperative recovery and near-to-mid-term outcomes. These findings suggest that this technique may represent a promising standardised minimally invasive alternative to conventional open surgery.