The study of clinical outcomes of extended thymectomy by robotic and video assisted thoracoscopic surgey for thymoma with myasthenia gravis / 中华胸心血管外科杂志

ABSTRACT

Objective To study the clinical outcomes of robotic extended thymectomy and thoracoscopic extended thymectomy for thymoma patients with myasthenia gravis compared with conventional median sternotomy extended thymectomy.Methods The clinical data of thymoma patients with myasthenia gravis treated by extended thymectomy between June 2013 and June 2016 were retrospectively reviewed.The clinical outcome parameters were compared according to surgical approach.Results 41 thymoma patients with myasthenia gravis,8 cases underwent robotic extended thymecotmy,11 cases underwent thoracoscopic extended thymectomy and 20 underwent median sternotomy extended thymectomy.The resected extension included tumor,thymus tissue and adipose tissue in anterior mediastinum.There were no significant differences between robotic group and thoracoscopic group regarding operative time,blood loss,chest tube duration,hospital stay,postoperative complications and postoperative myasthenic crisis (P ＞ 0.05).The blood loss of robotic group and thoracoscopic group was significantly lower than that in median sternotomy group(P ＜ 0.05).The chest tube duration of thoracoscopic group was significantly shorter than that in median sternotomy group(P ＜0.05).The effective rates of MG after extended thymectomy in robotic group,thoracoscopic group and sternotomy group was 65.0％ 、69.2％ 、62.5％ respectively and there was no significant difference (P ＜ 0.05).Conclusion Robotic thymectomy and thoracoscopic thymecotomy are both minimal invasive surgery approach with less bleeding for thymoma patients with myasthenia gravis.The clinical outcomes of robotic thymectomy and thoracoscopic thymecotomy are similar.