Objectives: Robotic thymectomy has been suggested and considered technically feasible for thymic tumors. 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 multicenter study sought to evaluate the early and long-term outcomes after robot-assisted thoracoscopic thymectomy in thymic epithelial tumors. Methods: All patients with thymic epithelial tumors operated through a robotic thoracoscopic approach between 2002 and 2022 from 15 Italian centers 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. Median diameter of tumor resected was 4cm (interquartile range 3-5.5cm), 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 tumor-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 tumors we demonstrated that robot-enhanced thoracoscopic thymectomy is a technically sound and safe procedure with a low complication rate and optimal oncological outcomes.

Robotic thymectomy in thymic tumors: a multicenter, nation-wide study / Comacchio, Giovanni Maria; Schiavon, Marco; Zirafa, Carmelina Cristina; De Palma, Angela; Scaramuzzi, Roberto; Meacci, Elisa; Bongiolatti, Stefano; Monaci, Nicola; Lyberis, Paraskevas; Novellis, Pierluigi; Brandolini, Jury; Parini, Sara; Ricciardi, Sara; D'Andrilli, Antonio; Bottoni, Edoardo; Gallina, Filippo Tommaso; Marino, Maria Carlotta; Lorenzoni, Giulia; Francavilla, Andrea; Rendina, Erino Angelo; Cardillo, Giuseppe; Rena, Ottavio; Solli, Piergiorgio; Alloisio, Marco; Luzzi, Luca; Facciolo, Francesco; Voltolini, Luca; Margaritora, Stefano; Curcio, Carlo; Marulli, Giuseppe; Ruffini, Enrico; Veronesi, Giulia; Melfi, Franca; Rea, Federico. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1873-734X. - ELETTRONICO. - (2024), pp. 0-0. [10.1093/ejcts/ezae178]

Robotic thymectomy in thymic tumors: a multicenter, nation-wide study

Meacci, Elisa;Rendina, Erino Angelo;Cardillo, Giuseppe;Voltolini, Luca;Rea, Federico
2024

Abstract

Objectives: Robotic thymectomy has been suggested and considered technically feasible for thymic tumors. 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 multicenter study sought to evaluate the early and long-term outcomes after robot-assisted thoracoscopic thymectomy in thymic epithelial tumors. Methods: All patients with thymic epithelial tumors operated through a robotic thoracoscopic approach between 2002 and 2022 from 15 Italian centers 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. Median diameter of tumor resected was 4cm (interquartile range 3-5.5cm), 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 tumor-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 tumors we demonstrated that robot-enhanced thoracoscopic thymectomy is a technically sound and safe procedure with a low complication rate and optimal oncological outcomes.
2024
0
0
Comacchio, Giovanni Maria; Schiavon, Marco; Zirafa, Carmelina Cristina; De Palma, Angela; Scaramuzzi, Roberto; Meacci, Elisa; Bongiolatti, Stefano; Mo...espandi
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1357817
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