Mid-Term Results for Robotic Thymectomy for Malignant Disease.

Ann Thorac Surg 2020 Sep 11. Epub 2020 Sep 11.

Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY.

Background: There are limited reports on robotic thymectomy for malignant disease. Our objectives are to review our experience and mid-term outcomes.

Methods: We reviewed a single surgeon prospective database for patients who underwent planned robotic resection for malignancy from January 2010 to June 2019.

Results: A total of 213 patients underwent resection of an anterior mediastinal mass, all of which were planned for a robotic approach. Of these, 84 (39%) underwent robotic thymectomy for malignant disease. Thymoma was the most common pathology resected (68%). Median tumor size was 4.7 cm (interquartile range 2.9-6.3) and median operative time was 81.5 minutes (interquartile range 64-104). All except one patient had a complete (R0) resection (98.8%). There were two (2.3%) unplanned, but elective conversions to open surgery, one of which required cardiopulmonary bypass. Median length of stay was one day (0-9) with one readmission (1.2%). Major morbidity occurred in 3 patients (3.5%) and there were no 30- or 90-day mortalities. In patients with thymoma, follow-up was complete at a median of 32 months (range 1-98) and one patient (1.8%) had an ipsilateral chest recurrence. To date, there have been no patient deaths.

Conclusions: Robotic thymectomy for patients with malignant disease is safe with excellent perioperative outcomes. A robotic approach achieves a high rate of complete R0 resection, even for larger tumors. For patients with thymoma, local recurrence is low after mid-term follow-up, but longer-term analysis is needed to determine oncologic durability.

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http://dx.doi.org/10.1016/j.athoracsur.2020.06.111DOI Listing
September 2020

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