Robotic surgery vs. open surgery for thymectomy, a retrospective case-match study

Luzzi, Luca; Corzani, Roberto; Ghisalberti, Marco; Meniconi, Fabiola; Leonibus, Lisa De; Molinaro, Francesco; Paladini, Piero

doi:10.1007/s11701-020-01109-z

Cited by 11 publications

(6 citation statements)

References 12 publications

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“…The reason may be that RATS can provide 3D magnified vision and more flexible equipment during the operation. 7 At the same time, it can eliminate hand tremor and accurately expose the complex anatomy around the resection target, which helps the surgeon perform precise operations. 31 It is better at controlling the bleeding of small blood vessels during the surgery.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 A number of studies have confirmed the feasibility and safety of VATS or RATS in the treatment of thymoma. [6][7][8][9][10] However, these studies are single-center and only include some small sample size, retrospective evaluation system studies, which limits their ability to obtain objective results. Therefore, there is no clear conclusion whether RATS can achieve an equal or even better surgical effect when compared with VATS in the treatment of thymoma.…”

Section: Introductionmentioning

confidence: 99%

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Robot‐assisted thoracic surgery versus video‐assisted thoracic surgery for treatment of patients with thymoma: A systematic review and meta‐analysis

Shen

et al. 2021

Thoracic Cancer

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Background: Surgical resection of the thymus is indicated in the presence of primary thymic diseases such as thymoma. Video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracic surgery (RATS) offer a minimally invasive approach to thymectomy. However, there is no clear conclusion whether RATS can achieve an equal or even better surgical effect when compared with VATS in treatment of thymoma. We performed this meta-analysis to explore and compare the outcomes of RATS versus VATS for thymectomy in patients with thymoma. Methods: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Medline, and Web of Science databases were searched for full-text literature citations. The quality of the articles was evaluated using the Newcastle-Ottawa Scale and the data analyzed using Review Manager 5.3 software. Fixed or random effect models were applied according to heterogeneity. Subgroup analysis was conducted.Results: A total of 11 studies with 1418 patients, of whom 688 patients were in the RATS group and 730 in the VATS group, were involved in the analysis. Compared with VATS, RATS was associated with less blood loss in operation, lower volume of drainage, fewer postoperative pleural drainage days, shorter postoperative hospital stay, and fewer postoperative complications. There was no significant difference in operative time and patients with or without myasthenia gravis between the two groups.Conclusions: RATS has more advantages over VATS, indicating that RATS is better than VATS in terms of postoperative recovery. We look forward to more large-sample, high-quality randomized controlled studies published in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robot‐assisted thoracic surgery versus video‐assisted thoracic surgery for treatment of patients with thymoma: A systematic review and meta‐analysis

Shen

et al. 2021

Thoracic Cancer

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“…A propensity matched retrospective cohort study comparing open vs robotic thymectomies found shorter hospital stays (5.25 ± 2.27 days vs 12.31 ± 13.62 days, p=0.003 for robot and open respectively) and no differences in operative time or postoperative complications (208.19 ± 99.69 min vs 195.69 ± 51.45 min robot and open respectively). Similar to the previous study, patients in the open group had higher postoperative pain scores as measured by a visual analog scale (VAS) compared to robot cases (p<0.001) however, this was not supported by a significant reduction in analgesic medication use [74]. Additionally, when discussing myasthenia gravis, it is important to consider complete remission rates.…”

Section: Robotic Vs Open Thymectomymentioning

confidence: 64%

Narrative Review of Surgery for Myasthenia Gravis

Dezube¹,

Deeb²,

Jaklitsch³

2021

obm neurobiol

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Myasthenia Gravis (MG) is a rare autoimmune disorder characterized by antibody mediated blockade of neuromuscular transmission. Up until the last decade, evidence suggesting benefit of thymectomy for myasthenia gravis has been based on non-randomized control studies. Our paper serves as an expert narrative review of new literature pertaining to surgical management of myasthenia gravis based on review of articles from PubMed and Cochrane database from date of inception through June 14, 2021. We used the MeSH search terms: “myasthenia gravis”; “thymectomy”; “thymoma”; and “surgery” to identify any new relevant articles for inclusion in our review. The results of these studies are summarized below. We reviewed multiple articles including two randomized control trials. As a result of these studies over the past decade, the American Academy of Neurology’s most recent practice advisory, published online March 25, 2020, gives a level ‘B’ recommendation for thymectomy for MG in patients with acetylcholine receptor antibody-positive generalized MG age 18-65 years old. They additionally noted the need for further discussion surrounding the benefits and risks of surgery and whether minimally invasive approaches to thymectomy would provide the same benefits as the traditional transsternal approach. Evidence recommending thymectomy during pregnancy remains limited due to lack of available data. Emerging evidence suggests that performance of video-assisted or robotic-assisted thymectomy is feasible, but further study is needed due to a lack of randomized control trials.

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“…Based on our inclusion/exclusion criteria, through full-text screening, we i denti fi ed 61 studi es for inclusi on. 1,3,[6][7][8]11,[13][14][15]21,22,[24][25][26][27][28][29][30][31][34][35][36][37][38][39][40][41][44][45][46][49][50][51][52][53][54][55][56][57][58][59][60][61][63][64][65][66][67][69][70][71][72]…”

Section: Resultsmentioning

confidence: 99%

Real-world data and evidence in pain research: a qualitative systematic review of methods in current practice

Vollert

Kleykamp

Farrar

et al. 2023

PR9

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The use of routinely collected health data (real-world data, RWD) to generate real-world evidence (RWE) for research purposes is a growing field. Computerized search methods, large electronic databases, and the development of novel statistical methods allow for valid analysis of data outside its primary clinical purpose. Here, we systematically reviewed the methodology used for RWE studies in pain research. We searched 3 databases (PubMed, EMBASE, and Web of Science) for studies using retrospective data sources comparing multiple groups or treatments. The protocol was registered under the DOI:10.17605/OSF.IO/KGVRM. A total of 65 studies were included. Of those, only 4 compared pharmacological interventions, whereas 49 investigated differences in surgical procedures, with the remaining studying alternative or psychological interventions or epidemiological factors. Most 39 studies reported significant results in their primary comparison, and an additional 12 reported comparable effectiveness. Fifty-eight studies used propensity scores to account for group differences, 38 of them using 1:1 case:control matching. Only 17 of 65 studies provided sensitivity analyses to show robustness of their findings, and only 4 studies provided links to publicly accessible protocols. RWE is a relevant construct that can provide evidence complementary to randomized controlled trials (RCTs), especially in scenarios where RCTs are difficult to conduct. The high proportion of studies reporting significant differences between groups or comparable effectiveness could imply a relevant degree of publication bias. RWD provides a potentially important resource to expand high-quality evidence beyond clinical trials, but rigorous quality standards need to be set to maximize the validity of RWE studies.

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Robotic surgery vs. open surgery for thymectomy, a retrospective case-match study

Cited by 11 publications

References 12 publications

Robot‐assisted thoracic surgery versus video‐assisted thoracic surgery for treatment of patients with thymoma: A systematic review and meta‐analysis

Robot‐assisted thoracic surgery versus video‐assisted thoracic surgery for treatment of patients with thymoma: A systematic review and meta‐analysis

Narrative Review of Surgery for Myasthenia Gravis

Real-world data and evidence in pain research: a qualitative systematic review of methods in current practice

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