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- Title
Robotic thymectomy in thymic tumours: a multicentre, nation-wide study.
- Authors
Comacchio, Giovanni Maria; Schiavon, Marco; Zirafa, Carmelina Cristina; Palma, Angela De; Scaramuzzi, Roberto; Meacci, Elisa; Bongiolatti, Stefano; Monaci, Nicola; Lyberis, Paraskevas; Novellis, Pierluigi; Brandolini, Jury; Parini, Sara; Ricciardi, Sara; D'Andrilli, Antonio; Bottoni, Edoardo; Gallina, Filippo Tommaso; Marino, Maria Carlotta; Lorenzoni, Giulia; Francavilla, Andrea; Rendina, Erino Angelo
- Abstract
OBJECTIVES Robotic thymectomy has been suggested and considered technically feasible for thymic tumours. However, because of small-sample series and the lack of data on long-term results, controversies still exist on surgical and oncological results with this approach. We performed a large national multicentre study sought to evaluate the early and long-term outcomes after robot-assisted thoracoscopic thymectomy in thymic epithelial tumours. METHODS All patients with thymic epithelial tumours operated through a robotic thoracoscopic approach between 2002 and 2022 from 15 Italian centres were enrolled. Demographic characteristics, clinical, intraoperative, postoperative, pathological and follow-up data were retrospectively collected and reviewed. RESULTS There were 669 patients (307 men and 362 women), 312 (46.6%) of whom had associated myasthenia gravis. Complete thymectomy was performed in 657 (98%) cases and in 57 (8.5%) patients resection of other structures was necessary, with a R0 resection in all but 9 patients (98.6%). Twenty-three patients (3.4%) needed open conversion, but no perioperative mortality occurred. Fifty-one patients (7.7%) had postoperative complications. The median diameter of tumour resected was 4 cm (interquartile range 3–5.5 cm), and Masaoka stage was stage I in 39.8% of patients, stage II in 56.1%, stage III in 3.5% and stage IV in 0.6%. Thymoma was observed in 90.2% of patients while thymic carcinoma occurred in 2.8% of cases. At the end of the follow-up, only 2 patients died for tumour-related causes. Five- and ten-year recurrence rates were 7.4% and 8.3%, respectively. CONCLUSIONS Through the largest collection of robotic thymectomy for thymic epithelial tumours we demonstrated that robot-enhanced thoracoscopic thymectomy is a technically sound and safe procedure with a low complication rate and optimal oncological outcomes.
- Subjects
THYMECTOMY; MYASTHENIA gravis; SURGICAL complications; TUMORS; ROBOTICS; DEMOGRAPHIC characteristics
- Publication
European Journal of Cardio-Thoracic Surgery, 2024, Vol 65, Issue 5, p1
- ISSN
1010-7940
- Publication type
Article
- DOI
10.1093/ejcts/ezae178