Myasthenie.com

J Thorac Dis. 2026 Jan 31;18(1):41. doi: 10.21037/jtd-2025-2011. Epub 2026 Jan 19.

ABSTRACT

BACKGROUND: Thymectomy is a cornerstone in the management of thymic epithelial tumors and myasthenia gravis (MG). While minimally invasive techniques like video-assisted thoracoscopic surgery (VATS) have gained prominence, robotic-assisted thoracoscopic surgery (RATS) has emerged as a technically advanced alternative. However, comparative long-term oncological outcomes between RATS and VATS remain underexplored. This review aims to compare RATS and VATS thymectomy regarding long-term outcomes, perioperative results, and cost.

METHODS: A systematic review was conducted following PRISMA guidelines, with a protocol registered in PROSPERO (CRD420251126351). PubMed/MEDLINE, Web of Science, and Cochrane Library were searched for comparative studies reporting long-term outcomes (≥12 months follow-up) of RATS versus VATS thymectomy. Risk of bias was assessed using the Newcastle-Ottawa Scale.

RESULTS: Three retrospective cohort studies (430 patients: 181 RATS, 249 VATS) were included. No significant differences were found in long-term oncological outcomes: 5-year progression-free survival (RATS 87.7% vs. VATS 90.6%, P=0.504) and overall survival (87.7% vs. 92.2%) were comparable. Recurrence and reoperation rates were low and similar between groups. In MG patients, RATS was associated with a higher rate of complete stable remission (26% vs. 18%, P=0.06) and was an independent predictor of remission (hazard ratio: 0.472, P=0.049). Perioperatively, RATS demonstrated advantages including lower conversion rates (3% vs. 15%, P=0.03), shorter operative time (median 100 vs. 120 min, P=0.039), and reduced hospital stay (mean 1.3 vs. 2.4 days, P=0.01). Complication rates were similarly low. However, RATS was significantly more costly (¥68,122 vs. ¥37,886, P

Source: https://pubmed.ncbi.nlm.nih.gov/4166044 ... 22+67771e2