关键词: 机器人, 胸腺瘤, 重症肌无力

Abstract: Objective  To systematically evaluate the safety and effectiveness of roboticassisted thoracoscopic surgery (RATS) and videoassisted thoracoscopic surgery (VATS) for thymectomy. Methods  A computerized search was conducted in PubMed, EMBASE, Cochrane library and CBM database for clinical studies on RATS comparing VATS. RevMan 5.3 was used for metaanalysis. Results  Nine casecontrol studies were included, including 668 patients undergoing thymectomy. Metaanalysis showed that the days of hospitalization in RATS group were less than those in VATS group (MD=-1.42, 95%CI［-2.32; -0.52］, P=0.002).The number of days of postoperative drainage was less than that in VATS group (MD=-0.70，95%CI［-1.26; -0.14］，P=0.01).The operation time was longer in RATS (MD=13.24，95%CI［3.82; 22.66］，P=0.006). The intraoperative blood loss showed no statistical difference between two groups (MD=-19.22，95%CI［-52.66; 14.22］，P=0.26).Transthoracic thoracotomy showed no statistical difference between two groups (OR=0.42, 95%CI［0.07; 2.35］, P=0.32). There was no statistical difference in the incidence of postoperative pneumonia between two groups (OR=0.72，95%CI［0.15; 3.42］，P=0.67).  There was no significant difference in the incidence of myasthenia gravis crisis between two groups (OR=0.61, 95%CI［0.17; 2.15］，P=0.45).  The overall incidence of postoperative complications was not statistically different between two groups (OR=1.4, 95%CI［0.42; 4.69］，P=0.59).Conclusion  The robotassisted thymectomy is safe and effective. There is no difference between two surgical methods: intraoperative blood loss, transthoracic thoracotomy and postoperative pneumonia complications, the incidence of myasthenia gravis crisis after surgery and overall postoperative complication rate.

Key words: robotics, thymoma, myasthenia gravis