WCLC 2025 - Posters & ePosters-EP.14.11 Comparison of Short Term Surgical Outcomes for Thymectomy With Various Minimally Invasive Approaches : A Single Center Experience

EP.14.11 Comparison of Short Term Surgical Outcomes for Thymectomy With Various Minimally Invasive Approaches : A Single Center Experience

Back to course

Pdf Summary

This single-center retrospective study from Asan Medical Center (2020-2024) compared short-term surgical outcomes of thymectomy performed with three minimally invasive approaches: lateral video-assisted thoracoscopic surgery (VATS), lateral robotic-assisted thoracoscopic surgery (RATS), and subxiphoid RATS. All techniques involved en bloc thymectomy with perithymic fat preservation and bilateral phrenic nerve protection. Surgical approach choice was per surgeon preference.<br /><br />Baseline characteristics (age, sex, tumor size, pathology, myasthenia gravis incidence) were similar across groups. Key findings showed that RATS approaches (both lateral and subxiphoid) had significantly longer operative times compared to VATS, primarily due to robotic setup (docking, arm adjustment) rather than console surgical time. No significant differences were observed among the groups in open conversion rates (~1-2.6%), chest tube duration, hospital stay (~3 days), postoperative pain scores, or complication rates (Clavien-Dindo grade III).<br /><br />Pain scores were comparable despite expectations that the subxiphoid RATS approach might reduce pain, likely because it also used bilateral intercostal ports. Advantages of RATS included enhanced dexterity from wristed instruments, superior visualization of the deep and upper thymic poles, and a potentially shorter learning curve relative to VATS. These features may offer oncologic benefits, though no long-term data were available.<br /><br />Limitations include the retrospective design, single-center experience, surgeon preference bias, relatively small RATS subgroup sizes, and absence of long-term oncologic outcomes.<br /><br />In conclusion, all three minimally invasive thymectomy approaches—VATS lateral, RATS lateral, and RATS subxiphoid—exhibited equivalent safety and efficacy in short-term outcomes. The main difference was longer operative time with robotic methods due to technical setup. Each approach can be effectively chosen based on surgeon preference for anterior mediastinal tumors without compromising perioperative outcomes.

Asset Subtitle

yohan bae

Meta Tag

Speaker yohan bae

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

thymectomy

minimally invasive surgery

video-assisted thoracoscopic surgery (VATS)

robotic-assisted thoracoscopic surgery (RATS)

subxiphoid approach

operative time

perioperative outcomes

myasthenia gravis

anterior mediastinal tumors

retrospective study