Robotic-assisted thoracoscopic surgery safe and effective for mediastinal cysts

A new study found that robotic-assisted thoracoscopic surgery is safe and effective when compared to video-assisted thoracoscopic surgery in the management of mediastinal cysts. The study results were published in the journal BMC Surgery. 

Mediastinal cysts are benign, asymptomatic cysts with low incidence. They are found during routine CT examinations for another disease. Any suspicious cysts need to be removed to avoid any complications. Compared to traditional thoracotomy, video-assisted thoracoscopic surgery (VATS) has many advantages. But due to the shortcomings of a thoracoscope, a robot-assisted surgery system (RATS) has emerged. RATS has been used for various thoracic surgeries, but literature showed limited use in mediastinal cysts resection. Hence, researchers from the Department of Thoracic Surgery, Gansu Provincial People’s Hospital, Gansu, China conducted a study to compare the efficacy and safety of RATS with VATS in the treatment of mediastinal cysts. 

The Department of Thoracic Surgery at the Gansu Provincial People's Hospital conducted a retrospective review of the clinical data from 70 instances of minimally invasive surgery for mediastinal cysts from April 2014 to December 2022. The RATS group had 34 cases with a cyst diameter of 3.70±1.16 cm and 4.07±1.20 cm in 36 cases in the VATS group. Using magnetic resonance imaging (MRI) or chest computed tomography (CT) localization, all cysts were assessed before surgery. Indicators associated with surgery were contrasted between the two groups. 

Key findings: 

• Participants in both groups completed the resection of mediastinal cysts without perioperative mortality.
• RATS group showed shorter operative time, lesser intraoperative bleeding, shorter postoperative chest drainage time, and shorter postoperative hospital stay when compared to the VATS group.
• No statistically significant discrepancy was seen in intermediate openings and complications in both groups (P > 0.05). 

Thus, with better short-term effectiveness than VATS, RATS is safe and practical for treating mediastinal cysts, and it may be vigorously pushed as an alternative to VATS.

Further reading: Hong, Z., Sheng, Y., Cui, B. et al. A comparative study of robotic surgery and thoracoscopic surgery for mediastinal cysts. BMC Surg 23, 102 (2023). https://doi.org/10.1186/s12893-023-01994-9