학술논문
Robotic thymectomy in thymic tumours: a multicentre, nation-wide study.
Document Type
Academic Journal
Author
Comacchio GM; Unit of Thoracic Surgery, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.; Schiavon M; Unit of Thoracic Surgery, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.; Zirafa CC; Robotic Multispecialty Centre for Surgery, Minimally Invasive and Robotic Thoracic Surgery, University Hospital of Pisa, Pisa, Italy.; De Palma A; Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari 'Aldo Moro', Bari, Italy.; Scaramuzzi R; Thoracic Surgery Unit, Monaldi Hospital, Naples, Italy.; Meacci E; Department of Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy.; Bongiolatti S; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy.; Monaci N; Thoracic Surgery Unit, University Hospital of Siena, Siena, Italy.; Lyberis P; Department of Surgical Sciences, Università degli Studi di Torino, Turin, Italy.; Novellis P; Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.; Università Vita-Salute San Raffaele, Milan, Italy.; Brandolini J; Department of Thoracic Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Parini S; Division of Thoracic Surgery, Ospedale Maggiore della Carità, Novara, Italy.; Ricciardi S; Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini Hospital, Rome, Italy.; D'Andrilli A; Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.; Bottoni E; Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Milan, Italy.; Gallina FT; Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.; Marino MC; Unit of Thoracic Surgery, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.; Lorenzoni G; Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.; Francavilla A; Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.; Rendina EA; Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.; Cardillo G; Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini Hospital, Rome, Italy.; Unicamillus, International University of Health Sciences, Rome, Italy.; Rena O; Division of Thoracic Surgery, Ospedale Maggiore della Carità, Novara, Italy.; Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.; Solli P; Department of Thoracic Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Alloisio M; Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Milan, Italy.; Luzzi L; Thoracic Surgery Unit, University Hospital of Siena, Siena, Italy.; Facciolo F; Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.; Voltolini L; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy.; Margaritora S; Department of Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy.; Curcio C; Thoracic Surgery Unit, Monaldi Hospital, Naples, Italy.; Marulli G; Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari 'Aldo Moro', Bari, Italy.; Department of Biomedical Sciences, Thoracic Surgery, Humanitas University, IRCCS Humanitas Research Hospital, Milan, Italy.; Ruffini E; Department of Surgical Sciences, Università degli Studi di Torino, Turin, Italy.; Veronesi G; Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.; Università Vita-Salute San Raffaele, Milan, Italy.; Melfi F; Robotic Multispecialty Centre for Surgery, Minimally Invasive and Robotic Thoracic Surgery, University Hospital of Pisa, Pisa, Italy.; Rea F; Unit of Thoracic Surgery, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
Source
Publisher: Oxford University Press Country of Publication: Germany NLM ID: 8804069 Publication Model: Print Cited Medium: Internet ISSN: 1873-734X (Electronic) Linking ISSN: 10107940 NLM ISO Abbreviation: Eur J Cardiothorac Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: Robotic thymectomy has been suggested and considered technically feasible for thymic tumours. 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 multicentre study sought to evaluate the early and long-term outcomes after robot-assisted thoracoscopic thymectomy in thymic epithelial tumours.
Methods: All patients with thymic epithelial tumours operated through a robotic thoracoscopic approach between 2002 and 2022 from 15 Italian centres 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. The median diameter of tumour resected was 4 cm (interquartile range 3-5.5 cm), 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 tumour-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 tumours we demonstrated that robot-enhanced thoracoscopic thymectomy is a technically sound and safe procedure with a low complication rate and optimal oncological outcomes.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Methods: All patients with thymic epithelial tumours operated through a robotic thoracoscopic approach between 2002 and 2022 from 15 Italian centres 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. The median diameter of tumour resected was 4 cm (interquartile range 3-5.5 cm), 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 tumour-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 tumours we demonstrated that robot-enhanced thoracoscopic thymectomy is a technically sound and safe procedure with a low complication rate and optimal oncological outcomes.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)