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Robotic-assisted thymectomy for early-stage thymoma: a propensity-score matched analysis

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Abstract

The aim of this study was to analyse the feasibility and safety of robotic-assisted thymectomy (RoT) in patients with clinically early stage thymoma, investigating clinical and early oncological results. Between 1998 and 2017, we retrospectively reviewed 76 (42.2%) patients who underwent radical thymectomy for clinically early stage thymoma (Masaoka-Koga I and II), identifying all patients who underwent RoT (n = 28) or open thymectomy (OT) with eligibility criteria for robotic surgery (n = 48). Using a propensity-score matched for tumor size (3.9 ± 1.8 cm) and stage (35% stage I, 42% stage IIA, 23% stage IIB), we paired 24 patients who had RoT with 24 patients undergoing OT. RoT was left-sided in 19 (79.2%) patients. None of the patients required conversion to open surgery. OT was via sternotomy in 21 (87.5%) patients and thoracotomy in 3 (12.5%). Mean operating time was shorter in the RoT group (117 ± 40 min) than in the OT (141 ± 46 min) (p = 0.06), even if not statistically significant. Length of stay was significantly shorter in the RoT group (mean 4.0 ± 1.9 days) than in the OT (mean 5.9 ± 1.7 days) (p = 0.0009). No significant difference between the two groups regarding post-operative complications. Five patients died in the OT group after a median follow-up of 6.1 years (only one for recurrence). After a median follow-up of 1.3 years, all patients in the RoT group were alive without disease. RoT is feasible and safe for early stage thymoma with clear advantage compared to OT in term of short term outcomes. A longer follow-up is needed to better evaluate the oncological results.

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Authors and Affiliations

  1. Division of Thoracic Surgery, European Institute of Oncology, University of Milan, Via G. Ripamonti, 435, 20141, Milan, Italy

    Monica Casiraghi, Domenico Galetta, Alessandro Borri, Adele Tessitore, Rosalia Romano, Daniela Brambilla & Lorenzo Spaggiari

  2. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy

    Patrick Maisonneuve

  3. Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy

    Lorenzo Spaggiari

Authors
  1. Monica Casiraghi
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  2. Domenico Galetta
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  3. Alessandro Borri
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  4. Adele Tessitore
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  5. Rosalia Romano
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  6. Daniela Brambilla
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  7. Patrick Maisonneuve
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  8. Lorenzo Spaggiari
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Correspondence to Monica Casiraghi.

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Monica Casiraghi, Domenico Galetta, Alessandro Borri, Adele Tessitore, Rosalia Romano, Daniela Brambilla, Patrick Maisonneuve and Lorenzo Spaggiari declare that they have no conflict of interest.

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Casiraghi, M., Galetta, D., Borri, A. et al. Robotic-assisted thymectomy for early-stage thymoma: a propensity-score matched analysis. J Robotic Surg 12, 719–724 (2018). https://doi.org/10.1007/s11701-018-0816-3

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  • DOI: https://doi.org/10.1007/s11701-018-0816-3

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