A comparative study between Da Vinci robotic surgery and traditional thoracoscopic surgery in thymomatectomy / 中华胸心血管外科杂志

ABSTRACT

Objective:To evaluate the clinical efficacy and prognosis of robotic-assisted thoracoscopic surgery (RATS )compared with traditional thoracoscopic surgery (VATS) in the treatment of thymoma.Methods:The clinical data of 128 patients with thymoma who underwent surgery in our hospital from January 2006 to November 2019 were retrospectively analyzed, There were 83 males and 45 females. The age ranged from 23 to 76 years old, with an average of (45.89±13.84) years old. The patients were divided into RATS group (58 cases) and VATS group (70 cases). Cox proportional risk model was used to analyze the factors affecting the postoperative hospital stay. Results:Compared with VATS group, RATS group patients had longer operation time[(128.61±32.13)min vs. (96.42±45.37)min, P=0.036], less intraoperative blood loss[(35.25±5.62)ml vs. (58.36±3.65)ml, P=0.016], less blood transfusion (1.72% vs. 7.14%, P=0.029), and less postoperative complications (17.2% vs. 22.9%, P=0.039). The average total hospitalization cost was higher [(56 721.18±98 457.24) yuan vs. (25 135.68±12 403.29) yuan, P<0.001], and the average postoperative hospitalization time was shorter[(4.15±1.51) days vs. (6.65±2.74)days, P<0.001], all with statistically significant differences. However, there was no statistical differences in conversion to thoracotomy, intraoperative complication, the surgical margin was positive, postoperative infectionpostoperative drainage amount, postoperative drainage time, expenses for medicine and anesthetic fee( P>0.05). Multiple linear regression models showed that different groups ( P=0.013), age ( P=0.025), combined with myasthenia gr avis( P=0.047), combined with underlying disease( P=0.016), intraoperative blood loss( P=0.034), conversion to thoracotomy ( P=0.024), postoperative infection( P=0.008), postoperative complications( P=0.026) and postoperative drainage time ( P=0.031) affected postoperative hospital stay. Conclusion:Robot-assisted thymectomy is a safe and effective method for the treatment of thymomas. RATS recover faster after surgery with fewer complications and shorter hospital stays than RATS after thoracoscopic surgery, but more large, high-quality studies are needed to evaluate the effectiveness of RATS.