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Published on: December 29, 2014
Comparison of Short-Term Surgical Outcomes for Thymectomy With Various Minimally Invasive Approaches: A Single-Centre
Yo Han Bae1, Yeong Min Lee1, In Ha Kim1
1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
Objectives:
Minimally invasive thymectomy, encompassing video-assisted thoracoscopic surgery and robotic-assisted thoracic surgery, is increasingly being adopted as an alternative to sternotomy. However, comparative data on commonly used minimally invasive techniques remain limited. This study aimed to compare the short-term surgical outcomes of 3 approaches: lateral video-assisted thoracoscopic surgery, lateral robotic-assisted thoracic surgery and subxiphoid robotic-assisted thoracic surgery.
Methods:
We retrospectively reviewed 292 patients who underwent minimally invasive thymectomy for anterior mediastinal masses between October 2020 and April 2024. Patients were categorized into 3 groups according to the surgical approach. Perioperative outcomes, including operating time, postoperative pain, hospital stay, and complications, were compared.
Results:
Of the 292 patients, 155 underwent lateral video-assisted thoracoscopic surgery; 70 underwent lateral robotic-assisted thoracic surgery; and 67 underwent subxiphoid robotic-assisted thoracic surgery. Operative time was significantly longer in both robotic-assisted thoracic surgery groups compared to video-assisted thoracoscopic surgery (lateral robotic-assisted thoracic surgery: 118.7 min; subxiphoid robotic-assisted thoracic surgery: 116.7 min; video-assisted thoracoscopic surgery: 93.5 min; P < .001). No significant differences were observed among the 3 groups in terms of postoperative pain, chest tube duration, hospital stay, complication rate, or R0 resection. No in-hospital deaths occurred.
Conclusions:
All 3 minimally invasive approaches for thymectomy demonstrated comparable short-term outcomes, although robotic-assisted thoracic surgery procedures had longer operating times. These findings suggest that lateral video-assisted thoracoscopic surgery, lateral robotic-assisted thoracic surgery, and subxiphoid robotic-assisted thoracic surgery are all safe and effective options, enabling surgeons to select the most appropriate technique based on individual patient characteristics and their surgical expertise.
