Comparison of perioperative outcomes of videothoracoscopy and robotic surgical techniques in thymoma

In this study, the perioperative outcomes of video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracoscopic surgery (RATS) were compared in patients with clinical stage I and stage II thymoma.

The outcomes of 24 patients (10 males and 14 females; mean age: 42.5 years; range: 18-65 years) with diagnoses of clinical stage I and stage II thymoma who underwent VATS in our clinic between April 2010 and March 2018 were compared with the outcomes of 21 patients (8 males and 13 females; mean age: 41.2 years; range: 19-63 years) with the same clinical stages of thymoma who underwent RATS between March 2013 and May 2018. The operative times, postoperative complications, lengths of hospital stay, and total amounts of chest tube drainage of the patients were evaluated.

No postoperative mortality was observed in either group. In general, VATS was performed from the right side, and RATS was performed from the right hemithorax. The operative time was significantly longer in the VATS group than in the RATS group (106.5 min versus 75.7 min, respectively; p < 0.001). In the VATS group, the total amount of postoperative drainage from the chest tubes was greater than that in the RATS group (210 ml versus 325 ml, respectively), and the drainage time was longer in the VATS group than in the RATS group (3 days versus 5 days, respectively; p < 0.001). The length of hospital stay was longer for the patients in the VATS group than for those in the RATS group (5.3 days versus 4.1 days, respectively; p < 0.001). The levels of pain were similar in both groups. No difference in the complication rates was found between the 2 groups.

In the treatment of clinical stage I and stage II thymoma patients, the robotic approach and excision with VATS are techniques with equal reliability. However, the use of robot-assisted thoracoscopic thymectomy technique is advantageous in terms of decreasing the total amount of postoperative drainage and shortening the length of hospital stay.