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Robotic thymectomy in thymic tumours: a multicentre, nation-wide study. | LitMetric

AI Article Synopsis

  • A large multicenter study across 15 Italian hospitals evaluated the early and long-term outcomes of robot-assisted thoracoscopic thymectomy for thymic epithelial tumors, enrolling 669 patients from 2002 to 2022.
  • The study found that most patients (98%) underwent complete thymectomy with a low incidence of open conversion (3.4%) and no perioperative mortality; however, 7.7% experienced postoperative complications.
  • Results showed effective oncological outcomes with only 2 patients dying from tumor-related causes during follow-up, and the 5- and 10-year recurrence rates were low at 7.4% and 8.3%, respectively, indicating the procedure's safety and effectiveness.

Article 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.

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Source
http://dx.doi.org/10.1093/ejcts/ezae178DOI Listing

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