Ahmed Ahmed, Abdel Aziz Tarek A, AlAsaad Mohannad M R, Majthoob Motaz, Souko Idriss, Emre Sert Dogan
Cardiothoracic Surgery Department, Ain Shams University, Cairo, Egypt.
Dubai Hospital, Dubai, United Arab Emirates.
J Robot Surg. 2025 Jul 25;19(1):421. doi: 10.1007/s11701-025-02601-0.
Thymectomy can be achieved through open surgery or minimally invasive approaches including video-assisted and robot-assisted thoracoscopic surgery. The present review aimed to compare the operative and postoperative outcomes of open and robot-assisted thymectomy (RAT) by analysis of published propensity score matched studies. Methods, The present systematic review was performed in line with recommendations of the Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) guidelines.
The ten studies included in this analysis were conducted on 1729 patients distributed as 919 patients (53.2%) in the open surgery arm and 810 patients (46.8%) in the RAT arm. Both interventions were comparable regarding duration of surgery, postoperative pain, frequency of intensive care unit (ICU) admission, frequency of postoperative complications, 30-day mortality, hospital readmission, tumor recurrence, 90-day mortality and overall mortality. Patients submitted to RAT had lower intraoperative blood loss [mean difference (95% CI): 185.24 (58.08-312.39)], shorter duration of chest drainage [mean difference (95% CI): 1.52 (1.43-1.60)], lower frequency of major postoperative complications [Risk Ratio (95% CI): 2.01 (1.18-3.42)], shorter duration of hospital stay [mean difference (95% CI): 2.31 (1.87-2.75)] and lower frequency of adjuvant radiotherapy [Risk Ratio (95% CI): 1.63 (1.09-2.44)].
Patients submitted to RAT experienced lower intraoperative blood, shorter duration of chest drainage, lower frequency of major postoperative complications, shorter duration of hospital stay, and lower frequency of adjuvant radiotherapy.
胸腺切除术可通过开放手术或微创方法实现，包括电视辅助和机器人辅助胸腔镜手术。本综述旨在通过分析已发表的倾向评分匹配研究，比较开放手术与机器人辅助胸腺切除术（RAT）的手术及术后结果。方法：本系统评价按照系统评价和Meta分析的首选报告项目（PRISMA）指南的建议进行。
本分析纳入的10项研究共涉及1729例患者，其中开放手术组919例（53.2%），RAT组810例（46.8%）。两种手术方式在手术时间、术后疼痛、重症监护病房（ICU）入住频率、术后并发症发生率、30天死亡率、再次入院率、肿瘤复发率、90天死亡率和总死亡率方面具有可比性。接受RAT的患者术中失血量更低[平均差异（95%CI）：185.24（58.08 - 312.39）]，胸腔引流时间更短[平均差异（95%CI）：1.52（1.43 - 1.60）]，术后主要并发症发生率更低[风险比（95%CI）：2.01（1.18 - 3.42）]，住院时间更短[平均差异（95%CI）：2.31（1.87 - 2.75）]，辅助放疗频率更低[风险比（95%CI）：1.63（1.09 - 2.44）]。
接受RAT的患者术中出血量更低，胸腔引流时间更短，术后主要并发症发生率更低，住院时间更短，辅助放疗频率更低。
