Comparison of surgical outcomes after robotic assisted thoracic surgery, video-assisted thoracic surgery and open resection of thymoma

BACKGROUND: Thymomas are the most common neoplasm in the anterior mediastinum. Surgical resection of thymomas remains the only curative treatment depending on the stage of the disease. Conventional resection has been performed through open surgery. However, minimal invasive and robotic assisted surgery are preferred if possible. METHODS: In a single center study three different surgical techniques were compared respectively, video-assisted thoracic surgery (VATS), robotic-assisted thoracic surgery (RATS) and open resection. In a period from 2006 to 2019 80 patients were included in the study and data were collected by retrospectively reviewing patient records. RESULTS: VATS and RATS had a significantly (P<0.05) shorter time with chest tube and shorter admission time compared to open surgery. Furthermore, VATS and RATS had significantly (P<0.05) lower blood loss per operatively compared to open surgery. There was no significant difference in operating time between the three groups. CONCLUSIONS: Minimal invasive surgery seems to be a safe surgical method in the treatment of thymomas. RATS and VATS were associated with a lower blood loss through surgery, shorter admission time and shorter chest tube time compared to open resection. RATS surgery might be considered for patients with a more advanced thymoma stage. Larger international multicenter randomized controlled trials are required to draw any conclusions regarding the oncological point of view.