Single Institution Experience With Robotic Thymectomy For Thymoma
Muhammad Haris Bin Iskandar, Anna L.W. Tam, Aneez D.B. Ahmed, Atasha Asmat.
Tan Tock Seng Hospital, Singapore, Singapore.
OBJECTIVE: Several centres have reported good outcomes with robotic-assisted thymectomy for thymoma. In our institution, the first robotic thymectomy was performed in 2012. The aim of our study is to review our institution’s experience with robotic thymectomy for thymoma.
METHODS: We retrospectively analysed all patients that underwent robotic assisted thymectomy for thymoma at our institution from 2012 to 2015. The following data were collected and reviewed : demographics, co-morbidities, operative data, morbidity and mortality.
RESULTS: Twenty patients underwent robotic-assisted thymectomy using a right-sided (n=8), left-sided (n=11) or bilateral (n=1) approach during the study period. Median age was 55 years (27-71 years) and 11 patients were female. Thirteen patients had myasthenia gravis. Median operative time was 121 minutes (71-380 min). World Health Organization (WHO) grade of thymoma were as follows: Type A (n=0), Type AB (n=4), Type B (n=8), Type C (n=1). Six patients had mixed WHO thymomas and 1 patient had a thymoma that could not be classified according to WHO criteria. The Masaoka stages were as follows: Stage I (n=7), Stage II (n=12) and Stage III (n=1). There was 1 conversion to median sternotomy because of concerns of great vessel invasion. One patient developed atrial fibrillation and there was no perioperative mortality. Median hospital stay was 3 days (2-13 days). At last follow up (median duration 27 months), 19 patients were alive and 1 had died of metastatic colorectal carcinoma. One patient with Stage I Type B2 thymoma experienced a recurrence at 15 months which was managed with surgical resection via median sternotomy.
CONCLUSIONS: Our experience suggests that robotic assisted thymectomy for thymoma can be performed safely and effectively. The benefits include reduced length of stay and early recovery. Outcomes at 1-year follow-up are promising. However, further studies to determine long-term outcomes will be required.
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