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Advantages of robot-assisted resection of large mediastinal tumors: a single-center preliminary study

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Current study aims to assess the safety and efficacy of robot-assisted thoracoscopic surgery (RATS) for sizable mediastinal masses with a minimum diameter ≥6 cm, compared with video-assisted thoracoscopic surgery (VATS) and open surgery. This study enrolled 130 patients with mediastinal tumors with no less than 6 cm diameter in Zhongnan Hospital, Wuhan University, including 33 patients who underwent RATS, 52 patients who underwent VATS and 45 patients who underwent open surgery. After classifying based on mass size and whether it has invaded or not, we compared their clinical characteristics and perioperative outcomes. There was no significant difference in age, gender, mass size, myasthenia gravis, mass location, pathological types (p > 0.05) in three groups. Patients undergoing open surgery typically presenting at a more advanced stage (p < 0.05). No obvious difference was discovered in the average postoperative length of stay, operation duration, chest tube duration and average postoperative day 1 drainage output between RATS group and VATS group (p > 0.05), while intraoperative blood loss in RATS group was significantly lower than VATS group (p = 0.046). Moreover, the postoperative length of stay, operation duration, chest tube duration and intraoperative blood loss in RATS group were significantly lower than open surgery group (p < 0.001). RATS is a secure and efficient approach for removing large mediastinal masses at early postoperative period. In comparison with VATS, RATS is associated with lower intraoperative blood loss. Compared with open surgery, RATS is also associated with shorter postoperative length of stay, operation duration, chest tube duration and intraoperative blood loss.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon reasonable request.


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We acknowledge the help of the staff in the operating room at Department of Thoracic Surgery, Zhongnan Hospital, Wuhan University in completing the study.


This work was supported by Zhongnan Hospital of Wuhan University Science, Technology and Innovation Seed Fund, Project LCYF202208.

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Authors and Affiliations



ZD and DL contributed equally to this work. NC, XW, JH, CL, JL and WH designed and finished the experiments. ZD and DL wrote the first draft. ZD, DL and WH analyzed the results and prepared all figures and tables. NC, XW, JH, CL, JL and WH critically revised drafts of the manuscript. WH provided important intellectual input and approved the final version for publication. All authors reviewed the manuscript.

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Correspondence to Weidong Hu.

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The authors have no relevant financial or non-financial interests to disclose.

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All human studies were conducted in accordance with the principles of the Declaration of Helsinki and all information of patients was obtained after approval of the Ethics Committee of Zhongnan Hospital, Wuhan University.

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The authors affirm that human research participants provided informed consent for publication of the images in Fig. 1a and b.

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Dong, Z., Liu, D., Cheng, N. et al. Advantages of robot-assisted resection of large mediastinal tumors: a single-center preliminary study. J Robotic Surg 18, 190 (2024).

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