Huang Luyu, Li Zhongmin, Li Feng, Zhang Hongbin, Zhang Wenqiang, Elsner Aron, Strauchmann Julia, Andreas Marco Nicolas, Dziodzio Tomasz, Lask Aina, Neudecker Jens, Ismail Mahmoud, Xie Daipeng, Zhou Haiyu, Meisel Andreas, Rueckert Jens-C
Department of Surgery, Competence Center of Thoracic Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany; Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Department of Surgery, Competence Center of Thoracic Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
J Thorac Cardiovasc Surg. 2025 Feb;169(2):469-483.e10. doi: 10.1016/j.jtcvs.2024.08.005. Epub 2024 Aug 17.
This study aims to evaluate the perioperative and midterm oncological outcomes of robotic-assisted thoracic surgery extended thymectomy for patients with large resectable thymomas compared with small thymomas.
This retrospective single-center study included 204 patients with thymomas who underwent robotic-assisted thoracic surgery extended thymectomy between January 2003 and February 2024. Patients were divided into 2 groups based on the thymoma size (5-cm threshold).
The study comprised 114 patients (55.9%) in the small thymoma group and 90 patients (44.1%) in the large thymoma group. No significant differences were found between the groups regarding gender, age, proportion of elderly patients, or pathologic high-risk classifications. Apart from a longer operative time (P = .009) in the large thymoma group, no differences were observed between the 2 groups regarding surgical parameters and postoperative outcomes. No deaths occurred within 30 days in either group. During a median follow-up of 61.0 months (95% CI, 48.96-73.04), 4 patients experienced recurrence (1.96%). No significant differences in the 5-year overall survival (P = .25) or recurrence-free survival (P = .43) were observed between groups.
Robotic-assisted thoracic surgery extended thymectomy is technically feasible, safe, and effective for treating large resectable thymomas. Moreover, midterm outcomes for patients with completely resected large thymomas were comparable to those with small thymomas during a median follow-up period of up to 5 years.
本研究旨在评估与小胸腺瘤患者相比，机器人辅助胸腔镜扩大胸腺切除术治疗可切除大胸腺瘤患者的围手术期及中期肿瘤学结局。
这项回顾性单中心研究纳入了2003年1月至2024年2月期间接受机器人辅助胸腔镜扩大胸腺切除术的204例胸腺瘤患者。根据胸腺瘤大小（以5厘米为界）将患者分为两组。
小胸腺瘤组有114例患者（55.9%），大胸腺瘤组有90例患者（44.1%）。两组在性别、年龄、老年患者比例或病理高危分类方面无显著差异。除大胸腺瘤组手术时间较长（P = 0.009）外，两组在手术参数和术后结局方面未观察到差异。两组均未发生30天内死亡。在中位随访61.0个月（95%CI，48.96 - 73.04）期间，4例患者出现复发（1.96%）。两组在5年总生存率（P = 0.25）或无复发生存率（P = 0.43）方面未观察到显著差异。
机器人辅助胸腔镜扩大胸腺切除术在技术上可行、安全且有效，可用于治疗可切除的大胸腺瘤。此外，在长达5年的中位随访期内，完全切除大胸腺瘤患者的中期结局与小胸腺瘤患者相当。
