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机器人胸腺切除术治疗胸腺瘤患者的长期结果。

Long-Term Outcomes of Robotic Thymectomy in Patients With Thymic Epithelial Tumors.

机构信息

Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.

Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.

出版信息

Ann Thorac Surg. 2021 Aug;112(2):430-435. doi: 10.1016/j.athoracsur.2020.09.018. Epub 2020 Oct 29.

Abstract

BACKGROUND

The long-term outcomes of robotic thymectomy for thymic epithelial tumors (TETs) are not well known, even though the early postoperative outcomes have improved. This study aimed to report the long-term survival and recurrence in patients with TETs who underwent robotic thymectomies.

METHODS

A total of 158 patients who underwent robotic thymectomy for TET and who were followed-up for more than 1 year were included in the study. The median follow-up time was 43 (interquartile range, 40) months, and 156 (98%) patients were followed completely until the end of the study period.

RESULTS

The mean age of the patients was 55.7 ± 12.7 years, and the mean size of the tumor was 4.6 ± 2.1 cm. There was no postoperative mortality and postoperative complications occurred in 7 (4.4%) patients. The median length of the postoperative hospital stay was 2 (interquartile range, 1-20) days. Thymoma was the most common cell type (n = 132, 84%), and thymic carcinoma (n = 24, 15%) and neuroendocrine tumors (n = 2, 1%) were the next most common types. Advanced stages more than stage III were identified in 15 patients (stage IIIA: n = 7, 4%; stage IVA: n = 5, 3%; and stage IVB: n = 3, 2%). The 5-year disease-specific survival was 100% in thymoma and 95% in thymic carcinoma. The 5-year recurrence-free survival was 94% in thymoma and 79% in thymic carcinoma.

CONCLUSIONS

Robotic thymectomy could achieve favorable long-term survival and recurrence rates, comparable to open or thoracoscopic thymectomy.

摘要

背景

尽管机器人胸腺切除术的早期术后结果已经得到改善,但对于胸腺瘤(TET)患者的长期预后尚不清楚。本研究旨在报告接受机器人胸腺切除术的 TET 患者的长期生存和复发情况。

方法

本研究共纳入 158 例接受机器人胸腺切除术治疗 TET 且随访时间超过 1 年的患者。中位随访时间为 43(四分位间距,40)个月,156(98%)例患者完整随访至研究期末。

结果

患者的平均年龄为 55.7±12.7 岁,肿瘤平均大小为 4.6±2.1cm。术后无死亡,7(4.4%)例患者发生术后并发症。术后平均住院时间为 2(四分位间距,1-20)天。胸腺瘤是最常见的细胞类型(n=132,84%),其次是胸腺癌(n=24,15%)和神经内分泌肿瘤(n=2,1%)。15 例患者(III 期 A 组:n=7,4%;IVA 期:n=5,3%;IVB 期:n=3,2%)分期超过 III 期。胸腺瘤 5 年疾病特异性生存率为 100%,胸腺癌为 95%。胸腺瘤 5 年无复发生存率为 94%,胸腺癌为 79%。

结论

机器人胸腺切除术可获得与开放性或胸腔镜胸腺切除术相当的良好长期生存和复发率。

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