Original Article
A comparative study between Da Vinci robotic surgery and traditional thoracoscopic surgery in thymomatectomy
Wang Bing, Jin Dacheng, Chen Meng, Yang Ning, Zhang Siyuan, He Xiaoyang, Gou Yunjiu
Published 2020-07-25
Cite as Chin J Thorac Cardiovasc Surg, 2020, 36(7): 420-424. DOI: 10.3760/cma.j.cn112434-20191126-00421
Abstract
ObjectiveTo evaluate the clinical efficacy and prognosis of robotic-assisted thoracoscopic surgery (RATS )compared with traditional thoracoscopic surgery (VATS) in the treatment of thymoma.
MethodsThe clinical data of 128 patients with thymoma who underwent surgery in our hospital from January 2006 to November 2019 were retrospectively analyzed, There were 83 males and 45 females. The age ranged from 23 to 76 years old, with an average of (45.89±13.84) years old. The patients were divided into RATS group (58 cases) and VATS group (70 cases). Cox proportional risk model was used to analyze the factors affecting the postoperative hospital stay.
ResultsCompared with VATS group, RATS group patients had longer operation time[(128.61±32.13)min vs. (96.42±45.37)min, P=0.036], less intraoperative blood loss[(35.25±5.62)ml vs. (58.36±3.65)ml, P=0.016], less blood transfusion (1.72% vs. 7.14%, P=0.029), and less postoperative complications (17.2% vs. 22.9%, P=0.039). The average total hospitalization cost was higher [(56 721.18±98 457.24) yuan vs. (25 135.68±12 403.29) yuan, P<0.001], and the average postoperative hospitalization time was shorter[(4.15±1.51) days vs. (6.65±2.74)days,P<0.001], all with statistically significant differences. However, there was no statistical differences in conversion to thoracotomy, intraoperative complication, the surgical margin was positive, postoperative infectionpostoperative drainage amount, postoperative drainage time, expenses for medicine and anesthetic fee(P>0.05). Multiple linear regression models showed that different groups (P=0.013), age (P=0.025), combined with myasthenia gr avis(P=0.047), combined with underlying disease(P=0.016), intraoperative blood loss(P=0.034), conversion to thoracotomy (P=0.024), postoperative infection(P=0.008), postoperative complications(P=0.026) and postoperative drainage time (P=0.031) affected postoperative hospital stay.
ConclusionRobot-assisted thymectomy is a safe and effective method for the treatment of thymomas. RATS recover faster after surgery with fewer complications and shorter hospital stays than RATS after thoracoscopic surgery, but more large, high-quality studies are needed to evaluate the effectiveness of RATS.
Key words:
Thymoma; Thoracoscopic surgery; Da Vinci robotic surgery; Prognosis
Contributor Information
Wang Bing
Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou 730000, China
Jin Dacheng
Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou 730000, China
Chen Meng
Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou 730000, China
Yang Ning
Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou 730000, China
Zhang Siyuan
Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou 730000, China
He Xiaoyang
Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou 730000, China
Gou Yunjiu
Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou 730000, China
