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Reply to "Robotic thymectomy for large thymomas: considering the impact of residual tumor complexity" and comment on "Robotic thymectomy for large thymomas: a multicenter study".

Journal of robotic surgery·2026

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Robotic thymectomy for large thymomas: a multicenter study.

Dania Nachira1, Maria Teresa Congedo2, Luca Bertolaccini3

  • 1Department of Thoracic Surgery, Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. danynac@libero.it.

Journal of Robotic Surgery
|June 19, 2025
PubMed
Summary
This summary is machine-generated.

Robot-assisted (RATS) thymectomy is a safe and effective alternative for large thymomas compared to open surgery. Oncological outcomes like overall survival and disease-free survival were similar between RATS and open approaches.

Keywords:
Large thymomasOutcomesRATSThymectomy

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Robotic Surgery

Background:

  • Thymomas are the most common primary tumors of the anterior mediastinum.
  • Large thymomas (≥5 cm) present unique surgical challenges.
  • Evaluating minimally invasive approaches for large thymomas is crucial.

Purpose of the Study:

  • To compare surgical and oncological outcomes of robot-assisted thymectomy (RATS) versus open thymectomy for large resectable thymomas.
  • To assess the safety and efficacy of RATS for large thymomas.

Main Methods:

  • Retrospective review of 301 thymectomies for thymoma across 7 high-volume centers (2010-2023).
  • Analysis included 191 patients with large thymomas (73 RATS, 118 open).
  • Propensity score matching (PSM) was used to minimize selection bias.

Main Results:

  • RATS for large thymomas showed similar conversion rates, significant complications, and hospital stay compared to small thymomas.
  • Compared to open surgery, RATS for large thymomas had fewer postoperative complications and shorter chest tube duration.
  • Five-year overall survival (OS) and disease-free survival (DFS) were comparable between RATS and open approaches for large thymomas.
  • Adjuvant radiotherapy was the only predictor of DFS.

Conclusions:

  • Robot-assisted thymectomy (RATS) is a safe and effective alternative to open surgery for large thymomas.
  • RATS offers comparable oncological outcomes to open surgery with potential advantages in postoperative recovery.
  • Further research may refine prognostic factors for thymoma recurrence.