Robotic thoracic surgery for resection of thymoma and tumors of the thymus: technical development and initial experience

Abstract

Objective: To evaluate the results of resection of tumors of the thymus by robotic thoracic surgery, analyzing the extent of resection, postoperative complications, time of surgery, and length of stay. Methods: Retrospective study from a database involving patients diagnosed with a tumor of the thymus and undergoing robotic thoracic surgery at one of seven hospitals in Brazil between October of 2015 and June of 2018. Results: During the study period, there were 18 cases of resection of tumors of the thymus: thymoma, in 12; carcinoma, in 2; and carcinoid tumor, in 1; high-grade sarcoma, in 1; teratoma, in 1; and thymolipoma, in 1. The mean lesion size was 60.1 ± 32.0 mm. Tumors of the thymus were resected with tumor-free margins in 17 cases. The median (interquartile range) for pleural drain time and hospital stay, in days, was 1 (1-3) and 2 (2-4), respectively. There was no need for surgical conversion, and there were no major complications. Conclusions: Robotic thoracic surgery for resection of tumors of the thymus has been shown to be feasible and safe, with a low risk of complications and with postoperative outcomes comparable to those of other techniques.

Directions for robotic surgery in the treatment of thoracic diseases in Brazil

“…Although the studies detailed above describe initial experiences in Brazil, (4,5) the morbidity and mortality rates reported are very similar to those reported in various international studies, (6) demonstrating that robotic surgery results in pleural drainage times and hospital stays are shorter than those reported for other techniques. (7) Oh et al (8) published results from a study of patients who underwent lobectomy in the USA.…”

“…The follow-up period was too short to provide estimates on cancer outcomes. With this report of their initial experience, (4) in the form of a case series, the authors demonstrated that robotic thoracic surgery for the treatment of thymic tumors is feasible and safe for use in Brazil.…”

“…In the field of thoracic surgery, the main applications of robotic surgery are in the treatment of lung cancer and mediastinal tumors. This issue of the JBP includes the largest studies to date presenting the Brazilian experience with robotic surgery in the treatment of tumors of the thymus (4) and lung cancer. (5) Terra et al (4) report their initial experience in a sample of 18 patients with tumors of the thymus who underwent robotic surgery at a total of seven centers in Brazil.…”

“…This issue of the JBP includes the largest studies to date presenting the Brazilian experience with robotic surgery in the treatment of tumors of the thymus (4) and lung cancer. (5) Terra et al (4) report their initial experience in a sample of 18 patients with tumors of the thymus who underwent robotic surgery at a total of seven centers in Brazil. The authors reported technical aspects and results, such as operative time, extent of resection, length of hospital stay, and postoperative complications.…”

“…In the field of thoracic surgery, the main applications of robotic surgery are in the treatment of lung cancer and mediastinal tumors. This issue of the JBP includes the largest studies to date presenting the Brazilian experience with robotic surgery in the treatment of tumors of the thymus 4 and lung cancer. 5 …”