AB057. Two decades of robotic thymectomy: trends and insights from a retrospective study
Original Research

AB057. Two decades of robotic thymectomy: trends and insights from a retrospective study

Giovanni M. Comacchio, Alessandro Bonis, Giuseppe Cataldi, Giulia Pagliarini, Eleonora Faccioli, Marco Mammana, Giorgio Cannone, Alessandro Rebusso, Samuele Nicotra, Marco Schiavon, Andrea Dell’Amore, Federico Rea

Thoracic Surgery Unit, University Hospital of Padua, Padua, Italy

Correspondence to: Giovanni M. Comacchio, MD. Thoracic Surgery Unit, University Hospital of Padua, Via Giustiniani 2, Padua, PD, 35128, Italy. Email: gcomacchio@gmail.com.

Background: Over the past decades, there has been a shift towards robotic resection for thymic tumors. The objective of our study was to characterize the transition to robotic-assisted thymectomy (RATS) in a historical cohort of patients undergoing thymectomy for thymic tumors.

Methods: We conducted a retrospective, single-center review of all robotic thymectomies for thymic epithelial tumors (TETs) between 2002 and 2022. Additionally, we analyzed data from patients who underwent resection of TETs using other approaches during the same period.

Results: During the study period, 348 patients were treated for TETs. The RATS group included 123 patients, 27% of whom were female, with a median [interquartile range (IQR)] age of 57 [48–66] years. Sixty-three (51%) patients had associated myasthenia gravis. In 16 (13%) cases, resection of structures other than the thymus was necessary. The conversion rate was 10%, with no intraoperative mortality. Pathological analysis revealed that most patients had a thymoma (97.6%), while there were only 2 cases of thymic carcinoma (1.6%) and 1 case of thymic carcinoid (0.8%). Tumor-node-metastasis (TNM) staging showed that the majority of patients had early-stage disease (stages I–II: 96%), with a median tumor size of 4.5 cm (range, 3–6 cm). The median duration of follow-up was 48 months (range, 24–72 months). There were 3 recurrences, and the 5-year disease-free survival (DFS) rate was 97%. While in the first half of our experience, RATS accounted for only 14% of thymectomies, in the latter half, this proportion increased to 45% (P<0.001), particularly for stage I–II cases (58%) (P<0.001). Additionally, we observed an increase in the dimension of lesions removed using the robotic approach (Figure 1), particularly the proportion of large tumors (≥5 cm) increased from 3% to 32% (P<0.001).

Conclusions: Over the past 20 years, there has been a significant shift towards robotic thymectomy, particularly for early-stage disease. With increasing experience, more advanced-stage tumors and larger lesions are being considered for a robotic approach.

Keywords: Thymoma; robot; recurrence; trends

Figure 1 Distribution of the resected tumors’ dimension stratified by year-range. RATS, robotic-assisted thymectomy.

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-25-ab057/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the institutional board of Padua University Hospital (No. 5400/AO/22) and individual consent for this retrospective analysis was waived.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/med-25-ab057
Cite this abstract as: Comacchio GM, Bonis A, Cataldi G, Pagliarini G, Faccioli E, Mammana M, Cannone G, Rebusso A, Nicotra S, Schiavon M, Dell’Amore A, Rea F. AB057. Two decades of robotic thymectomy: trends and insights from a retrospective study. Mediastinum 2025;9:AB057.

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