Robotic subxiphoid thymectomy versus lateral thymectomy: a propensity score-matched comparison.

Area of Science:

• Thoracic surgery
• Minimally invasive surgery
• Surgical oncology

Background:

• Anterior mediastinal tumors require effective surgical treatment.
• Robotic thymectomy offers advantages over traditional methods.
• Robotic subxiphoid thymectomy (RXT) is a newer technique compared to lateral approaches.

Purpose of the Study:

• To compare surgical outcomes between conventional robotic lateral thymectomy and robotic subxiphoid thymectomy (RXT).
• To evaluate the safety and efficacy of RXT for anterior mediastinal tumors, particularly those in challenging locations.

Main Methods:

• Propensity score matching was used to analyze data from 389 patients who underwent robotic thymectomy.
• 141 matched pairs of patients receiving either RXT or lateral thymectomy were included.
• Surgical outcomes, including complication rates, hospital stay, and postoperative pain, were compared.

Main Results:

• Both methods demonstrated comparable demographic and pathological features after matching.
• RXT was more frequently used for tumors abutting the brachiocephalic vein.
• RXT was associated with significantly higher brachiocephalic vein resection rates but comparable complication rates.

Conclusions:

• Robotic subxiphoid thymectomy (RXT) is a safe and effective approach for complex anterior mediastinal tumors.
• RXT demonstrates superior early outcomes, including shorter hospital stays and reduced postoperative pain compared to robotic lateral thymectomy.