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Robotic Thymectomy Is Feasible for Large Thymomas: A Propensity-Matched Comparison
Peter J Kneuertz1, Mohamed K Kamel1, Brendon M Stiles1
1Department of Cardiothoracic Surgery, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, New York.
The Annals of Thoracic Surgery
|September 23, 2017
Summary
Robotic-assisted thymectomy (RAT) is safe and effective for large thymomas, showing reduced blood loss and shorter hospital stays compared to sternal thoracotomy. Long-term outcomes require further investigation.
Area of Science:
- Thoracic Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Robotic-assisted thymectomy (RAT) is increasingly used for thymoma resection.
- Its efficacy for large thymomas is debated, necessitating comparative studies.
Purpose of the Study:
- To evaluate the safety and feasibility of RAT for large thymomas (≥4 cm).
- To compare perioperative outcomes of RAT versus transsternal thymectomy (ST) for large thymomas.
Main Methods:
- A retrospective review of patients undergoing RAT for large thymomas (2004-2016).
- Propensity score matching was used to compare RAT with ST patients based on key characteristics.
- Perioperative outcomes including blood loss, hospital stay, and complications were analyzed.
Main Results:
- Twenty RAT patients and 34 ST patients were analyzed, with similar tumor size and Masaoka staging.
- RAT was associated with significantly lower blood loss (25 mL vs. 150 mL) and shorter median length of stay (3 days vs. 4 days).
- Complication rates (15% vs. 24%) and R0 resection rates (90% vs. 85%) were similar between groups, with no perioperative deaths.
Conclusions:
- Robotic-assisted thymectomy is a safe and effective approach for radical resection of large thymomas.
- Further research is needed to ascertain the long-term oncologic outcomes of RAT for large thymomas.
