Lee Jun Hee, Hwang Jinwook, Park Tae Hyun, Gu Byung Mo, Jung Younggi, Yi Eunjue, Lee Sungho, Hwang Soon Young, Chung Jae Ho, Kim Hyun Koo
Department of Thoracic and Cardiovascular Surgery, Guro Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea.
Cancers (Basel). 2024 Aug 15;16(16):2856. doi: 10.3390/cancers16162856.
Subxiphoid thymectomy is a novel alternative to the transthoracic approach and sternotomy, with potential benefits, such as reduced postoperative pain and faster recovery. We previously reported the initial experience with subxiphoid single-port robotic-assisted thoracic surgery (SRATS) thymectomy using the single-port robotic system (SPS). However, the efficacy of this technique remains unknown. Thus, this study examined the multi-institutional experience with SRATS thymectomy and compared the perioperative outcomes of this technique to those of subxiphoid single-port video-assisted thoracic surgery (SVATS) thymectomy. The data of patients who underwent subxiphoid SRATS and SVATS thymectomy, performed by three thoracic surgeons at three institutions between September 2018 and May 2024, were retrospectively collected. In total, 110 patients were included, with 85 and 25 undergoing SRATS and SVATS thymectomy, respectively. After propensity score matching, 25 patients were included in each group. The SRATS group was associated with a lower conversion rate to multi-port surgery (0% vs. 20%, = 0.05), shorter chest tube drainage duration (1.32 ± 0.75 vs. 2.00 ± 1.29 days, = 0.003), and a shorter postoperative hospital stay (2.52 ± 1.00 vs. 5.08 ± 5.20 days, = 0.003). Subxiphoid SRATS thymectomy using the SPS is feasible and is a good alternative to conventional thymectomy. Further studies are necessary to confirm its benefits.
剑突下胸腺切除术是一种替代经胸入路和胸骨切开术的新方法，具有潜在的益处，如减轻术后疼痛和加快恢复。我们之前报告了使用单孔机器人系统（SPS）进行剑突下单孔机器人辅助胸外科手术（SRATS）胸腺切除术的初步经验。然而，该技术的疗效尚不清楚。因此，本研究考察了SRATS胸腺切除术的多机构经验，并将该技术的围手术期结果与剑突下单孔电视辅助胸外科手术（SVATS）胸腺切除术的结果进行了比较。回顾性收集了2018年9月至2024年5月期间在三个机构由三位胸外科医生进行剑突下SRATS和SVATS胸腺切除术的患者数据。总共纳入了110例患者，其中85例和25例分别接受了SRATS和SVATS胸腺切除术。经过倾向评分匹配后，每组纳入25例患者。SRATS组转为多端口手术的发生率较低（0%对20%，P = 0.05），胸管引流时间较短（1.32±0.75天对2.00±1.29天，P = 0.003），术后住院时间较短（2.52±1.00天对5.08±5.20天，P = 0.003）。使用SPS进行剑突下SRATS胸腺切除术是可行的，是传统胸腺切除术的良好替代方法。需要进一步研究以证实其益处。
