[Pubmed] Robotic thymectomy in thymic tumors: a multicenter, nation-wide study

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Eur J Cardiothorac Surg. 2024 Apr 25:ezae178. doi: 10.1093/ejcts/ezae178. Online ahead of print.

ABSTRACT

OBJECTIVES: Robotic thymectomy has been suggested and considered technically feasible for thymic tumors. However, because of small-sample series and the lack of data on long-term results, controversies still exist on surgical and oncological results with this approach. We performed a large national multicenter study sought to evaluate the early and long-term outcomes after robot-assisted thoracoscopic thymectomy in thymic epithelial tumors.

METHODS: All patients with thymic epithelial tumors operated through a robotic thoracoscopic approach between 2002 and 2022 from 15 Italian centers were enrolled. Demographic characteristics, clinical, intraoperative, postoperative, pathological and follow-up data were retrospectively collected and reviewed.

RESULTS: There were 669 patients (307 men and 362 women), 312 (46.6%) of whom had associated myasthenia gravis. Complete thymectomy was performed in 657 (98%) cases and in 57 (8.5%) patients resection of other structures was necessary, with a R0 resection in all but 9 patients (98.6%). Twenty-three patients (3.4%) needed open conversion, but no perioperative mortality occurred. Fifty-one patients (7.7%) had postoperative complications. Median diameter of tumor resected was 4cm (interquartile range 3-5.5cm), and Masaoka stage was stage I in 39.8% of patients, stage II in 56.1%, stage III in 3.5% and stage IV in 0.6%. Thymoma was observed in 90.2% of patients while thymic carcinoma occurred in 2.8% of cases. At the end of the follow-up, only 2 patients died for tumor-related causes. Five and ten-year recurrence rates were 7.4% and 8.3%, respectively.

CONCLUSIONS: Through the largest collection of robotic thymectomy for thymic epithelial tumors we demonstrated that robot-enhanced thoracoscopic thymectomy is a technically sound and safe procedure with a low complication rate and optimal oncological outcomes.

PMID:38663851 | DOI:10.1093/ejcts/ezae178


Source: https://pubmed.ncbi.nlm.nih.gov/3866385 ... t9+e462414