Abstract
The robotic approach in the treatment of thymus diseases has been described in many papers, but few studies have compared the early outcome of patients after robotic and open transsternal procedure. Our study aims to confirm the non-inferiority of the robotic technique in terms of feasibility, safety and postoperative patient recovery compared to the open standard. This is a retrospective cohort study in which we compare 114 patients who underwent thymectomy for a thymus disease at our thoracic surgery unit. Our robotic surgery programme started in February 2012 with the treatment of mediastinal diseases. Since then, we have performed 57 robotic thymectomies (Group A). This series was compared with 57 patients who underwent open thymectomies (Group B) performed before 2012, and all were properly matched through a propensity score. Hospital and ICU stay, postoperative pain, use of painkillers, operative time and complications rate were analysed. Postoperative pain, evaluated through the Visual Analogue Scale (VAS), was significantly lower in the robotic surgery group (p < 0.001), which was associated with a trend to lower use of painkillers in Group A, although it was not significant (p = 0.06). No statistical differences were observed between the two groups in terms of ICU stay (p = 0.080), although the total hospital stay was significantly longer in Group B (p = 0.003). No statistical differences were observed in operative time (p = 0.492) and complications rate (p = 0.950). The robotic-assisted technique showed the same operative time and complications rate compared with open surgery, thereby confirming its safety and feasibility in myasthenic patients as well as in Masaoka I–II thymomas. The lower postoperative pain and the shorter hospital stay associated with prompt mobilisation and faster chest drainage removal showed the great advantage of the minimally invasive robotic approach in these patients.
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Luca Luzzi, Roberto Corzani, Marco Ghisalberti, Fabiola Meniconi, Lisa De Leonibus, Francesco Molinaro and Piero Paladini declare that they have no conflict of interest and no grants were obtained for this study.
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We declare that the paper “ROBOTIC SURGERY VS OPEN SURGERY FOR THYMECTOMY, A RETROSPECTIVE CASE-MATCH STUDY” has never been published in any journal before. The study was carried out by the retrospective analysis of patients’ clinical files and all procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
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Luzzi, L., Corzani, R., Ghisalberti, M. et al. Robotic surgery vs. open surgery for thymectomy, a retrospective case-match study. J Robotic Surg 15, 375–379 (2021). https://doi.org/10.1007/s11701-020-01109-z
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DOI: https://doi.org/10.1007/s11701-020-01109-z