Post-Operative Outcomes Associated With Open Versus Robotic Thymectomy: A Propensity Matched Analysis
| Autor: | Stephan Adamour Soder, Edwin Lafontaine, Basil S. Nasir, Jocelyne Martin, Moishe Liberman, Clare Pollock, Pasquale Ferraro |
|---|---|
| Rok vydání: | 2023 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Surgical approach business.industry medicine.medical_treatment technology industry and agriculture Retrospective cohort study General Medicine Oncologic surgery Surgery body regions Thymectomy Surgical time Propensity score matching medicine Post operative Cardiology and Cardiovascular Medicine business human activities |
| Zdroj: | Seminars in Thoracic and Cardiovascular Surgery. 35:189-199 |
| ISSN: | 1043-0679 |
| Popis: | To compare post-operative outcomes associated with thymectomy performed using either open or robotic approaches. Retrospective cohort study from a single-center prospective registry consisting of patients undergoing thymectomy between 2000 and 2020. Patients were grouped according to surgical approach (open vs robotic). A propensity-score matching analysis was performed in a 2:1 open to robotic ratio, and surgical outcomes were evaluated. We analyzed 234 thymectomies (155 open; 79 robotic). Myasthenia gravis was present in 23.2% and 32.9% (P = 0.249) in the open and in the robotic group, respectively. All covariates were balanced in the matched groups (open n = 114; robotic n =5 9), except lesion size. The robotic approach was significantly associated with shorter surgical time (median 95 vs 65 minutes, P0.001), lesser clinical (21.1% vs 6.8%, P = 0.016) and surgical (11.4% vs 1.7%, P = 0.036) complications during the same hospitalization, less Clavien-Dindo grade 2 or higher complication rates (28.1 vs 15.3%, P = 0.048), chest tube duration (median: 3 vs 0 days, P0.001) and in-hospital length of stay (median: 5 vs 0 days, P0.001). Bleeding (P = 0.214), ICU length of stay (P = 0.167), reoperation rate (open, 1.8% vs robotic 0%), 90-day mortality (P = 0.341) and readmission rate post discharge (P = 0.277) were similar between the groups. In the matched population with primary thymic epithelial tumors, the completeness of resection rate was similar (open, 92.1% vs robotic 96.8%, P = 0.66.). Robotic thymectomy is associated with improved post-operative outcomes when compared to open thymectomy, without compromising the goals of oncologic surgery. Longer follow-up is needed to ensure oncologic equivalence. |
| Databáze: | OpenAIRE |
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