Robotic Resection of 3 Cm and Larger Thymomas is Associated with Low Perioperative Morbidity and Mortality

Wilshire, Candice L.; Vallières, Eric; Shultz, Dale; Aye, Ralph W.; Farivar, Alexander S.; Louie, Brian E.

doi:10.1177/155698451601100503

Cited by 1 publication

(3 citation statements)

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“…Characteristics are listed in Table 1. [31–36] Of a total of 489 patients, 215 (44%) were undergoing RVATS, while 274 (56%) experienced open surgery. The number of patients included into these studies varied between 6 and 100 per study for RVATS and between 15 and 100 for open sternotomy.…”

Section: Resultsmentioning

confidence: 99%

“…Two out of seven studies used propensity score matching to reduce bias. [31,32] Indication for open surgery or RVATS were anterior mediastinal masses, [31,32] thymoma [33–36] (classified using the Masaoka [33] or the WHO classification), [34] thymic cysts, thymic hyperplasia, [34,35] or myasthenia gravis. [24] Out of 215 interventions performed by RVATS (7 studies included), 4 were converted to open sternotomy.…”

Section: Resultsmentioning

confidence: 99%

“…[40–42] During the past 5 years, many authors from established general thoracic centers reported studies that supported the feasibility, reproducibility, effectiveness, and safety of the robotic-assisted procedures compared with the open thymectomy. [24,31–36] To the best of our knowledge, this is the first meta-analysis comparing these 2 surgical techniques of thymectomy.…”

Section: Discussionmentioning

confidence: 99%

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Thymectomy via open surgery or robotic video assisted thoracic surgery

Buentzel¹,

Straube²,

Heinz³

et al. 2017

Medicine

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Background:Robot-assisted minimally invasive surgery (RVATS) is a relatively new technique applied for thymectomies. Only few studies directly compare RVATS to the mainstay therapy, open surgery (sternotomy).Methods:A systematic search of the literature was performed in October 2016. The meta-analysis includes studies comparing robotassisted and open thymectomy regarding operation time, length of hospitalization, intraoperative blood loss, and chest-in-tube days, postoperative complications, reoperation, arrhythmic events, pleural effusion, and postoperative bleeding.Results:Of 626 studies preliminary screened, 7 articles were included. There were no significant differences in comparison of operation time (−3.19 minutes [95% confidence interval, 95% CI −112.43 to 106.05]; P = .94), but patients undergoing RVATS spent significantly less time in hospital (−4.06 days [95% CI −7.98 to −0.13], P = .046). There were fewer chests-in-tube days (−2.50 days [95% CI −15.01 to 10.01]; P = .24) and less intraoperative blood loss (−256.84 mL [95% CI −627.47 to 113.80]; P = .10) observed in the RVATS group; due to a small number of studies, these results were not statistically significant. There were also less post-operative complications in the RVATS group (12 complications in 209 patients vs 51 complications in 259 patients); however, this difference was not statistical significant (odds ratio 0.27, 95% CI 0.07–1.12; P = .06).Conclusions:Patients undergoing RVATS spent less time in hospital than patients treated by open surgery (sternotomy). These patients tended to have less postoperative complications, less intraoperative blood loss, and fewer chest-in-tube days. We found evidence for the safety and feasibility of RVATS compared with open surgery, which has to be further confirmed in randomised controlled trials.

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Section: Resultsmentioning

confidence: 99%