Department of Thoracic Surgery, Daping Hospital, Army Medical University, No. 10, Changjiang Route, Yuzhong District, Chongqing, 400042, China.
BMC Surg. 2023 Oct 27;23(1):330. doi: 10.1186/s12893-023-02228-8.
Both video-assisted thoracoscopic surgery (VATS) thymectomy and robot-assisted thoracoscopic surgery (RATS) thymectomy have been suggested as technically sound approaches for early-stage thymic epithelial tumors. However, the choice of VATS or RATS thymectomy for large and advanced thymic epithelial tumors remains controversial. In this study, the perioperative outcomes of VATS and RATS thymectomy were compared in patients with large thymic epithelial tumors (size ≥5.0 cm).
A total of 113 patients with large thymic epithelial tumors who underwent minimally invasive surgery were included. Sixty-three patients underwent RATS, and 50 patients underwent VATS. Patient characteristics and perioperative variables were compared.
Compared with the VATS group, the RATS group experienced a shorter operation time (median: 110 min vs.130 min; P < 0.001) and less blood loss (30.00 ml vs. 100.00 ml, P < 0.001). No patients in the RATS group needed conversion to open surgery, but in the VATS series, five patients required conversion to open procedures (0% vs. 14.29%, P = 0.054). The rate of concomitant resection in the RATS group was similar to that in the VATS group (11.43% vs. 5.71%; P = 0.673). There was no significant difference between the two groups in the duration of chest tube (P = 0.587), postoperative complications (P = 1.000), and the duration of postoperative hospital stay (P = 0.141).
For large thymic epithelial tumors, RATS thymectomy can be performed safely and effectively in a radical fashion. Due to the advanced optics and precise instrument control, concomitant resections can be easily achieved in larger thymic epithelial tumors using the robotic approach.
视频辅助胸腔镜手术（VATS）胸腺切除术和机器人辅助胸腔镜手术（RATS）胸腺切除术均被认为是早期胸腺瘤的技术可靠方法。然而，对于大型和晚期胸腺瘤，选择 VATS 还是 RATS 胸腺切除术仍存在争议。在这项研究中，比较了 VATS 和 RATS 胸腺切除术在大型胸腺瘤（大小≥5.0cm）患者中的围手术期结果。
共纳入 113 例接受微创外科手术的大型胸腺瘤患者。63 例患者接受 RATS，50 例患者接受 VATS。比较患者特征和围手术期变量。
与 VATS 组相比，RATS 组的手术时间更短（中位数：110min 比 130min；P<0.001），出血量更少（30.00ml 比 100.00ml，P<0.001）。RATS 组无患者需要转为开放手术，但在 VATS 组中有 5 例需要转为开放手术（0%比 14.29%，P=0.054）。RATS 组的同时切除率与 VATS 组相似（11.43%比 5.71%；P=0.673）。两组间胸腔引流管时间（P=0.587）、术后并发症（P=1.000）和术后住院时间（P=0.141）无显著差异。
对于大型胸腺瘤，RATS 胸腺切除术可以安全有效地进行根治性切除。由于先进的光学和精确的器械控制，使用机器人方法可以轻松地在更大的胸腺瘤中进行同时切除。
