Long‐term outcomes of robot versus video-assisted thymectomy for thymic epithelial tumors: a propensity matched analysis

Abstract

Abstract Background Robot-assisted thoracoscopic surgery (RATS) thymectomy has been increasingly performed for treating thymic epithelial tumors in recent years. However, there are very limited reports on the long-term oncologic outcomes after RATS thymectomy, particularly in comparison to Video-assisted thoracoscopic surgery (VATS). This study aimed to compare the perioperative and long-term oncological outcomes between RATS and VATS. Methods The study was conducted on 180 consecutive patients undergoing RATS or VATS between July 2016 and December 2019, 85 of whom underwent RATS, and 95 of whom underwent VATS. A 1:1 matched propensity score-matched analysis was performed and the perioperative and long-term oncologic outcomes of the two groups compared. Result RATS group experienced a shorter operation time (median: 100 min vs. 120 min; P = 0.039) and less blood loss (40.00 ml vs. 50.00 ml, P = 0.011). RATS demonstrated a significantly lower conversion rate to open surgery compared to VATS, with only two patients requiring conversion in the RATS group as opposed to ten patients in the VATS group (3.03% vs. 15.15%, P = 0.030). In the RATS group, the 5-year progression-free survival rate was 87.70%, and the 5-year tumor-related survival rate was 92.31%, demonstrating no statistically significant difference compared to those in the VATS group. Conclusion Compared with VATS, robotic thymectomy demonstrated excellent perioperative outcomes, and RATS achieved long-term oncologic outcomes comparable to those of VATS. RATS thymectomy could be considered as an effective alternative approach for treating thymic epithelial tumors.

Keywords

• Thymic epithelial tumor
• Robot-assisted thoracoscopic surgery
• Video-assisted thoracoscopic surgery
• Perioperative outcomes
• Survival