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Robotic Surgery compared with Median Sternotomy for Thymic Mass Resection
Anna L.W. Tam, Atasha Asmat, Aneez D.B. Ahmed.
Tan Tock Seng Hospital, Singapore, Singapore.
OBJECTIVE: The aim of this study was to compare outcomes between
open and robotic surgery for resection of thymic masses.
METHODS: A retrospective review was conducted on patients with
surgically resected thymic masses from 2000 to 2014. Data collected included: Patients’ demographics, history of myasthenia gravis (MG), medical co-morbidities, and histopathology. Post-operative morbidity and mortality were analyzed and compared.
RESULTS: A total of 49 patients were eligible for this study.
20 underwent open surgery via median sternotomy (40.8%), 29 underwent robotic surgery (59.2%). Patients’ characteristics and outcomes are presented in the figure and stratified according to surgical approach. 
Post-operative complications occurred in 3 patients who had Open surgery, and none of the Robotic surgery patients (p=0.062). One patient
required re-opening for bleeding, and the other 2 patients developed myasthenic crisis post-operatively. In patients with thymoma, the Masaoka stages and World Health Organisation (WHO) grades were similarly distributed across both groups.
CONCLUSIONS: Our study shows that the robotic approach in resection of thymic masses is associated with a decreased post-operative Intensive Care Unit (ICU) and hospital length of stay. Robotic surgery is currently the approach of choice at our institution in suitably selected patients.
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