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Robotic vs. Transsternal Thymectomy: A Single Center Experience over 10 Years
Luis Filipe Azenha1, Robin Deckarm1, Fabrizio Minervini2
1Division of General Thoracic Surgery, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Journal of Clinical Medicine
|November 13, 2021
Summary
Robot-assisted thoracic surgery (RATS) offers a minimally invasive option for thymectomy, showing shorter hospital stays and smaller tumor sizes compared to transsternal (TS) approaches. Oncological outcomes remain comparable between RATS and TS thymectomies.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Thymomas are the most common mediastinal tumors.
- Traditional thymectomies utilize the transsternal (TS) approach.
- Robot-assisted thoracic surgery (RATS) presents a minimally invasive alternative.
Purpose of the Study:
- To compare the oncological and surgical outcomes of RATS versus TS thymectomies.
- To evaluate the efficacy of RATS for thymoma resection.
- To assess the suitability of RATS for myasthenia gravis treatment.
Main Methods:
- Retrospective analysis of 104 patients undergoing anterior mediastinal tumor resection (January 2010 - November 2020).
- Procedures included RATS (n=81) and TS (n=22) thymectomies.
- Surgical approach selection based on preoperative CT scan findings (tumor invasion, size).
Main Results:
- RATS group: median length of stay (LOS) 3.2 days, median tumor size 4.4 cm.
- TS group: median LOS 9 days, median tumor size 10.4 cm.
- Statistically significant differences in LOS and tumor size (p < 0.001); complete resection achieved in all patients.
Conclusions:
- RATS is a viable alternative for thymoma resection up to 9.5 cm.
- TS approach remains suitable for larger, invasive tumors like thymic carcinomas.
- Surgical approach does not impact oncological outcomes or survival rates.
