Robotic Thymectomy Matches VATS in Long-Term Outcomes, Excels in Perioperative Results: Study
Researchers have found that robotic-assisted thoracoscopic surgery (RATS) thymectomy delivers outstanding perioperative outcomes with equivalent long-term oncological outcomes when compared to video-assisted thoracoscopic surgery (VATS) in treating thymic epithelial tumors. A recent study was conducted by Long-Fei and colleagues which was published in the journal BMC Surgery.
The study involved an analysis of data from 180 patients who underwent thymectomy through RATS or VATS between July 2016 and December 2019. Of these, 85 patients were operated on by RATS, and 95 patients were operated on by VATS. To allow for balanced comparisons, the analysis was done with a 1:1 propensity score-matched approach. The analysis was focused on perioperative factors, including operation time, blood loss, and conversion rates to open surgery, and long-term oncological outcomes, such as 5-year progression-free survival and tumor-related survival rates.
Key Results
Perioperative Outcomes:
• Operation Time: The median operation time was significantly shorter in the RATS group, 100 minutes, compared to the VATS group, 120 minutes (p = 0.039).
• Blood Loss: The patients in the RATS group had less blood loss with a median of 40.00 ml compared to the VATS group, 50.00 ml (p= 0.011).
• Conversion Rates: Conversion to open surgery was remarkably less in the RATS group with only 2 patients (3.03%) compared with 10 patients (15.15%) in the VATS group (p= 0.030).
Late Oncological Outcomes :
Progression-Free Survival
• The 5-year progression-free survival rate was found out to be 87.70% in the RATS group which is equal to the overall percentage of the VATS group.
• Tumor-Related Survival: The 5-year tumor-related survival rate for the RATS group was 92.31%, without any statistical significance when compared with the VATS group.
RATS thymectomy resulted in excellent perioperative outcomes and long-term oncologic results compared with VATS. Based on these data, RATS can be considered as an effective and efficient alternative to VATS for thymic epithelial tumor treatment. Due to the possibility of combining the perioperative advantages with reliable long-term results, RATS will have an important position in the surgical treatment of thymic malignancies.
Reference:
Zhu, L.-F., Zhang, L.-M., Zuo, C.-J., Jiang, B., & Cheng, N. (2024). Long‐term outcomes of robot versus video-assisted thymectomy for thymic epithelial tumors: a propensity matched analysis. BMC Surgery, 24(1). https://doi.org/10.1186/s12893-024-02661-3
