Thymectomy via open surgery or robotic video assisted thoracic surgery: Can a recommendation already be made?
2017 | journal article. A publication with affiliation to the University of Göttingen.
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Thymectomy via open surgery or robotic video assisted thoracic surgery: Can a recommendation already be made?
Buentzel, J. ; Straube, C.; Heinz, J. ; Roever, C. ; Beham, A. ; Emmert, A. & Hinterthaner, M. et al. (2017)
Medicine, 96(24) pp. e7161. DOI: https://doi.org/10.1097/MD.0000000000007161
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Details
- Authors
- Buentzel, Judith ; Straube, Carmen; Heinz, Judith ; Roever, Christian ; Beham, Alexander ; Emmert, Andreas; Hinterthaner, Marc ; Danner, Bernhard C. ; Emmert, Alexander
- Abstract
- Robot-assisted minimally invasive surgery (RVATS) is a relatively new technique applied for thymectomies. Only few studies directly compare RVATS to the mainstay therapy, open surgery (sternotomy). A systematic search of the literature was performed in October 2016. The meta-analysis includes studies comparing robotassisted and open thymectomy regarding operation time, length of hospitalization, intraoperative blood loss, and chest-in-tube days, postoperative complications, reoperation, arrhythmic events, pleural effusion, and postoperative bleeding. Of 626 studies preliminary screened, 7 articles were included. There were no significant differences in comparison of operation time (3.19 minutes [95% confidence interval, 95% CI 112.43 to 106.05]; P=.94), but patients undergoing RVATS spent significantly less time in hospital (4.06 days [95% CI 7.98 to 0.13], P=.046). There were fewer chests-in-tube days (2.50 days [95% CI 15.01 to 10.01]; P=.24) and less intraoperative blood loss (256.84mL [95% CI 627.47 to 113.80]; P=.10) observed in the RVATS group; due to a small number of studies, these results were not statistically significant. There were also less post-operative complications in the RVATS group (12 complications in 209 patients vs 51 complications in 259 patients); however, this difference was not statistical significant (odds ratio 0.27, 95% CI 0.07 – 1.12; P=.06). Patients undergoing RVATS spent less time in hospital than patients treated by open surgery (sternotomy). These patients tended to have less postoperative complications, less intraoperative blood loss, and fewer chest-in-tube days. We found evidence for the safety and feasibility of RVATS compared with open surgery, which has to be further confirmed in randomised controlled trials.
- Issue Date
- 2017
- Journal
- Medicine
- ISSN
- 0025-7974
- eISSN
- 1536-5964
- Language
- English
- Sponsor
- Open-Access-Publikationsfonds 2017