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Videoassisted thoracoscopic versus robotic--assisted thoracoscopic thymectomy:a systematic review and metaanalysis

  

  1. 1. Department of Clinical Medicine,  Gansu University of Traditional Chinese Medicine,  Lanzhou  730000,  China;
    2. Department of  Thoracic Surgery,  Gansu Province People’s Hospital,  Lanzhou  730000,  China
  • Online:2019-02-20 Published:2019-03-11
  • Contact: Corresponding author:Gou Yunjiu, Email:gouyunjiu@163.com

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