Robot-assisted thymectomy is superior to transsternal thymectomy

Complete thymectomy is the procedure of choice in the treatment of thymomas and in treating selected patients with myasthenia gravis. Transsternal thymectomy is the gold standard for most patients. Robot-assisted thymectomy has emerged as an alternative to open transsternal surgery. The goal of this study was to compare perioperative outcomes in patients who underwent transsternal or robot-assisted thymectomy.

We performed a retrospective review of all patients who underwent robot-assisted or transsternal thymectomy at our institution from February 2001 to February 2010. Data are presented as mean ± SD. Significance was set as P < 0.05.

Fifty patients underwent either transsternal (n = 35) or robot-assisted (n = 15) thymectomy. Patient demographics and the incidence of myasthenia gravis were similar between groups. There were no intraoperative complications or conversions to open surgery in the robot-assisted group. Intraoperative blood loss was significantly higher in the transsternal group (151.43 vs. 41.67 ml, P = 0.01). There were 20 postoperative complications and 1 postoperative death in the transsternal group and 1 postoperative complication in the robot-assisted group (P = 0.001). Hospital length of stay was 4 days (range 2-27 days) in the transsternal group and 1 day (range 1-7 days) in the robot-assisted group (P = 0.002).

Robot-assisted thymectomy is superior to transsternal thymectomy, reducing intraoperative blood loss, postoperative complications, and hospital length of stay. Further investigation of the long-term oncologic results in thymoma patients and long-term remission rates in patients with myasthenia gravis who underwent robot-assisted thymectomy is warranted.